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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 provides assurance for compliance with third party liability requirements outlined in the Consolidated Appropriates Act (CAA) of 2022
Summary: This SPA proposed to revise the state’s reimbursement rate for physician administered drugs such that it will continually align with the Medicare Fee Schedule reimbursement rate.
Summary: Makes a DSH payment add-on per FFS and managed care day; the daily add-on is tiered dependent on the qualifying facility's Medicaid day to total ratio. This additional DSH pool will not be redistributed if overpayments occur, but recouped and federal share returned.
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 provide one-time lump sum supplemental payments to non-emergency medical transportation (NEMT) providers for the period beginning July 1, 2022 through April 30, 2023. This amendment also waives signature requirements for the dispensing of drugs during the public health emergency, effective March 1, 2020.
Summary: This SPA implements Wisconsin's yearly increase to hospital rates. Specifically, this SPA modifies the outpatient Enhanced Ambulatory Patient Grouping Reimbursement Methodology to create a new outpatient payment per visit add-on for outpatient dental services where deep sedation is provided.
Summary: To adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: The State adopts the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
