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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 modifies the State's reimbursement methodology for setting payment rates for nursing facility services. Specifically, the amendment will freeze rates in effect on July 1, 2009 for hospital swing beds and nursing facility services.
Summary: This amendment implements the Medicare Improvements for Patients and Providers Act (MIPPA) provisions with regard to the Medicare Saving Program Resource Limits.
Summary: This amendment elevates the standards for providers and changes service definitions. Provider qualifications now include specificity in education to assure service provision by qualified providers.
Summary: This amendment limits eyeglass frames for adults twenty-one (21) years of age and older to one pair every two years and lenses to one pair every three hundred and sixty five days.
Summary: Apply an overall negative inflationary adjustment of 4.16 percent for SFY 2010 and freeze rates for SFY 2011. This change is required due to the State administrative decision to freeze existing rates effective July 1, 2009 and effective October 1, 2009 to implement negative inflationary adjustments for SFY 2010.
Summary: This amendment define Georgia's managed care program by adding refugees as an eligible group; increasing the time frame for recipients to choose a health plan from fifteen to thirty days; and by incorporating quality and cost weighted scoring within the auto-assignment algorithm.
Summary: Adjusts State Fiscal Year (SFY) 2010 and freezes SFY 2011 rates for case management services based on an overall program reduction of 9.807 percent for SFY 2010. SFY 2011 rates are frozen at the SFY 2010 amount.
Summary: The State requests approval of this amendment to provide for administration of the H1N1 influenza vaccine by licensed practitioners to adults, age twenty-one and over.