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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: Proposes to allow the state to comply with the Medicaid Drug Utilization review (DUR) provisions included in 1004 of the SUPPORT for Patients and Communities Act with the effective date of October 1, 2019.
Summary: Updates the amounts of Arizona's graduate medical education and indirect medical education payment pools and the qualifying hospital list for each payment pool for the fiscal period ending June 30, 2019
Summary: Updates the list of eligibility groups for which wages paid by the Census Bureau for temporary employment related to Census activities are exempt
Removes references to “broker” or “brokering from the description for non-emergency transportation (NEMT). NE no longer directly brokers with transportation providers for services. For beneficiaries receiving their Medicaid through Managed Care, NEMT services have been added to the MCO contracts as of July 1, 2019. NE will reimburse NEMT fee for service for all other Medicaid beneficiaries
Summary: Increases Inpatient Hospital service payment rates by two percent (2%) and inpatient Psychiatric payment rates by four percent 4% over levels previously in effect.
Summary: Rebases Nursing Facility and Intermediate Care Facility for Individuals with Intellectual Disabilities payment rates. Provider reported base costs are adjusted so that State fiscal 2020 NF and ICF-IID payment rates will result in aggregate expenditures remaining within legislative appropriation increases.