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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 eliminates a 5% rate reduction; implements a hospital adjustment factor; and provides for disproportionate share hospital (DSH) payment redistribution methodology.
Summary: This SPA makes conforming changes to the State Plan to Implement a system to screen all participating providers according to their categorical risk level , upon initial enrollment and upon re-enrollment or revalidation of enrollment.
Summary: Develop and provide an Asset Verification System, that ,meets the requirements of Section 1940(a) of the Social Security Act, to determine or redetermine Medicaid eligibility for aged, blind and disabled Medicaid applicants and recipients.
Summary: This amendment imposes a 5% rate reduction on all medical supplies provided from July 1, 2011 to June 30, 2013. This SPA also seeks to change the methodology of Medical Supply reimbursement to utilize Medicare rates as the reimbursed amount when available, or the acquisition cost when Medicare rates are not available.
Summary: This SPA makes changes to the State Plan as a result of Section 4107 of the Affordable Care Act that amends section 1905 of the Social Securoity Act to require coverage of counseling and pharmacotherapy for cessation of tobacco use by pregnant women.
Summary: This amendment makes changes to the State plan to modify provider requirements during an audit, revise the related party definition and the requirement to receive a related party exception, and clarify the administrative reconsideration and appeals process.
Summary: Which propose to disregard recipient resources in an amount equal to the insurance benefit payments made to or on behalf of an individual who is a beneficiary under a long-term care insurance policy, in accordance with the provisions of Section 6021 of the Deficit Reduction Act of 2005.
