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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: Decreases amount of resources that a spouse of an institutionalized individual can retain known as the Community Spouse Protected Amount (CSPA).
Summary: Designation of community mental health centers as health homes for individuals with a serious and persistent mental health condition and at least one other chronic condition.
Summary: Proposes to amend/clarify state plan language for home health agencies, community mental health centers, and maternal health centers in response to the CMS corrective action plan for approved SPA MS-09-021.
Summary: Revises the Disproportionate Share Hospital qualifying criteria and payment methodologies for non+rural community hospitals; to revise the state appropriation for certain DSH categories; and to allow for additional payments after completion of the CMS mandated DSH independent audit for the state fiscal year.
Summary: Restructure Reimbursement for Proprietary Nursing Homes & Across the Board Reduction-LTC FMAP - 56.88% for 4/1/11-6/30/11; 50% 7/1/11 forward.
Summary: Changes the methodology for updating nursing home rates quarterly for changes in acuity and resource needs during a traditional period while the State migrate from using the Vermont-specific RUG-III method of categorizing residents to the new Federal classification system known as RUG-IV which utilizes MDS 3.0.