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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a 10% rate increase for providers of Title XIX Home and Community Based Services as follows: (HCB) Personal Care Services, 1915(k) Community First Choice Services (CFC), and Long-Term Services and Supports Targeted Case Management Services(LTSS-TCM). The department intends this increase to facilitate increased wages and promote the hiring and retention of HCBS direct service workers, an area adversely impacted by the COVID-19 pandemic.
Summary: Updates the inpatient hospital reimbursement methodology for Indirect Graduate Medical Education (IME) payments to specify calculation of annual IME payments based on the most recently filed and available cost reports. The amendment also adds inpatient state directed payment arrangements allowed under 42 CFR 438.6(c) approved pre-prints and made through managed care plans (“Inpatient DRG Enhanced Rate”) to the calculation of annual IME payments.
Summary: This amendment updates third-party liability and payment of claims in accordance with requirements in the Bipartisan Budget Act (BBA) of 2018 and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019.
Summary: This amendment adds optometry services to the state plan, revises coverage of eyeglasses/contact lens, and adds a fee-for-service payment methodology for these benefits.
Summary: This plan amendment updates the language regarding the auditing practices utilized within the County Health Department Reimbursement methodology.
Summary: This state plan amendment updates the description of Florida Agency for Health Care Administration (AHCA) procedures for audits of Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), specifying that audits shall be based on American Institute of Certified Public Accountants (AICPA) Attestation Standards for examining or reviewing statistical information and data.
Summary: This state plan amendment specifies the reporting period of the Nursing Facility provider Fair Rental Value (FRV) survey, sets out the procedures for reporting FRV projects, and clarifies the scope of capital costs that can be reported as part of a project. It also updates the glossary entries for relevant terms.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add an end date to previously approved emergency provisions due to the COVID-19 Public Health Emergency.