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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: Eliminates DSH Health Relief Subsidy Fund payments (ii) revises the inpatient hospital supplemental Hospital Relief Subsidy Fund (HRSF) and Graduate Medical Education (GME) supplement payment allocation methodologies and amounts, and (iii) effective October 1, 2012 sunsets all hospital supplemental payments, as required by Special Terms and Conditions #9l(c) of the New Jersey 1115 Waiver.
Summary: Updates the personal services fee schedule, the nursing facility budget dial rate, and the swing bed rates and clarifies the reimbursement policy for therapy services provided in nursing facilities.
Summary: Revises the Ambulatory Patient Group methodology for hospital-based clinic and ambulatory surgery services, including emergency room services.