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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: Adds Alameda Hospital and San Leandro Hospital to the list of government operated hospitals and updates language on the cost reports used for government operated hospitals.
Summary: This SPA was submitted to my office on September 16, 2016 to request an exception from renewing the Recovery Audit Contractor (RAC) under Section 1902(a)(42)(B)(i) of the Social Security Act once the agreement expires on January 1, 2017. CMS is granting this exception request based on the documentation provided by the Department that it has active program integrity contractors performing work similar to RAC.
Summary: This amendment makes various changes to the Medi-Cal program's estate recovery program, including limiting estate recovery to probated estates for only federally-mandated services; adding a hardship waiver criterion for a "homestead of modest value;" eliminating recovery from surviving spouses and registered domestic partners; and updating the interest rate for voluntary liens.
Summary: Authorizes the Skilled Nursing Facility Quality and Accountability Supplemental Payment (QASP) System for the rate year beginning August 1, 2016.
Summary: This amendment makes technical revisions to update the home health section of the state plan to align with regulatory updates to Title 42 CFR 440.70.
Summary: To remove the following counties from the list of geographic areas offering Targeted Case Management (TCM) services for the "Individuals with a Communicable Disease" TCM group: Butte, El Dorado, Fresno, Marin, Merced, Monterey, Napa, Placer, San Francisco, San Luis Obispo, San Mateo, Santa Barbara, Santa Cruz, Tulare, Tuolumne, and Yolo.
Summary: To remove the following counties from the list of geographic areas offering Targeted Case Management (TCM) services for the "Individuals in Jeopardyof Negative Health or Psycho-Social Outcomes" TCM group: Fresno, Merced, San Francisco, Santa Barbara, Tulare and Yolo.
Summary: To remove the following counties from the list of geographic areas offering Targeted Case Management (TCM) services for the Individuals at risk of Institutionalization TCM group Fresno, Merced, San Francisco, San Mateo, Santa Barbara, Tulare and Yolo.
Summary: To remove the following counties from the list of geographic areas offering Targeted Case Management (TCM) services for the Medically Fragile Individuals TCM group Butte, Fresno, Marin, Merced, San Francisco, San Joaquin, Santa Barbara, Tulare and Yolo.
Summary: This amendment places the Comprehensive Perinatal Service Program (CPSP) providers under the clinic benefit as part of the reimbursement for Indian Health Service (IHS) and Tribal 638 facilities and makes related clarifications.
