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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: Reductions in payment rates and changes in payment standards for inpatient hospital and NFs related to across the board budget cuts made by the Governor.
Summary: Eliminates certain optional services and imposes limitations on other optional services for adults age 21 and older Specifically, this SPA eliminates podiatrists services preventive dental services and well and physical exams. This SPA also limits prosthetics coverage and organ transplantation Dental services also are limited to treatments of oral disease prior to transplantation and to extractions prior to treatment of certain cancers.
Summary: Aligns the resource limit for Qualified Medicare Beneficiaries Specified Low Income Medicare Beneficiaries and Qualifying Individuals with the resource limit for individuals who qualify for the full subsidy under the Medicare Part D Low Income Subsidy program.
Summary: Adjusts State Fiscal Year (SFY) 2010 rates for Rehabilitation Services based on an overall program reduction of 4.68 percent for SFY 2010. SFY 2011 rates are to be frozen at the SFY 2010 amount.
Summary: Implements Section 1915j authority for self directed personal assistance services to transition Medi Cal beneficiaries currently receiving services through the In-Home Supportive Services Plus Section 1115 Demonstration project which expires on September 30, 2009.