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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: Implements Section 5006 e of the Recovery Act, which mandates that States consult withTribes and designees of Indian health programs on State plan amendments, waiver requests, or proposals for a demonstration project that are likely to have a direct effect on Indians.
Summary: Adds a limit to crown for adults, two per year and update orthodontia payment from 'by report' to a fee schedule, this also changes the date the agency's rates were set.
Summary: Limitations on Estate Recovery - Medicare Cost Sharing as specified at 4.17 (b) (3 cont) for qualified dual eligibles age 55 and over, for dates of service on or after 1/1/2010.
Summary: This State Plan Amendment addresses the new requirements regarding Estate Recovery under section 1917(b)(1) of the Social Security Act by encouraging dual eligible beneficiaries to fully utilize Medicare cost-sharing benefits available through the Medicare Savings Program.
Summary: Clarifies the limitations place on medical and surgical services proficed by a dentist and corrects the preprint numbering relating to this item.
Summary: Prohibits the estate recovery of Medicare cost sharing benefits for dual eligible beneficiaries age 55 and over in compliance with Section 115 of the Medicare Improvements for Patients and Providers Act of 2008.