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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: This amendment makes the resource limit for Qualified Medicaid Beneficiaries, Specified low-income Medicare Beneficiaries and QIs three times the Supplemental Security Income resource limit, adjusted annually by the increase in the Consumer Price Index as set forth by the Medicare Inprovement for patients and Providers Act of 2008.
Summary: Adjusts the reimbursement rates for selected services provided by physicians and to reduce the reimbursement rates for anesthesia services provided by physicians.
Summary: This request modifies the nursing facility rate setting for implementation of a nursing facility provider tax (quality assurance assessment fee).
Summary: Continues the $25 monthly capitated payment to Medicare Advantage Plans and Special Needs Plans who have entered into a Medicare Risk Product Agreement with the Centers for Medicare & Medicaid Services.
Summary: This amendment modifies the State's reimbursement methodology for setting payment rates for nursing facility services. Specifically, the amendment updates the cost center percentages used to calculate the weighted trend factors for the annual rate increases and deletes obsolete language.