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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: The SPA provides for the continuation of various cost saving measures, which had been enacted previously and were to sunset, for hospital outpatient clinic, emergency department, certified home health agency, adult day health and freestanding clinic services.
Summary: This SPA transmitted revisions to reimbursement language for transportation and therapies, and clarifications to coverage language for home health, private duty nursing, therapies, hospice, respiratory care, and certified pediatric/family nurse practitioner services.
Summary: Establishes home and community based services under the 1915(i) state plan option for Adult Behavioral Health Services concurrent with the Behavioral Health 1915(b) waiver under a capitated contract reimbursement methodology.
Summary: To implement a conflict-free case management, adds a small population of clients transitioning into the community from nursing facilities and revises the current reimbursement methodology for targeted case management beneficiaries age 60 and older.