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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: Reimbursement for medical equipment and medical supplies into compliance with the 21st Century Cures Act of 2016 and State Medicaid Director letter 18-001.
Summary: The Quality Assurance Fee (QAF) program and reimbursement add-on for Ground Emergency Medical Transports (GEMT) provided by emergency medical transportation providers to Medi-Cal patients.
Summary: Proposes to repeal the provisions governing radiation utilization management services in order to align with the current fee-for-service and managed care practices relative to prior authorization of high-end radiology services.
Summary: Updates SPRY 2019 pool amounts for hospital DSH payment adjustments and Supplemental Access Payments up to the hospital specific DSH limit also private psychiatric hospitals only to the "Deemed DSH" payment methodology.