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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: Amends provisions governing reimbursement for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in order to establish an alternative payment methodology which would allow reimbursement outside of the
current Prospective Payment System rate for community health worker services provided in FQHCs and RHCs.
Summary: amends rate year ((RY) 2022 updates to reimbursement methods and standards for privately-owned psychiatric hospitals, and administrative updates only for substance abuse treatment hospitals.
Summary: This amendment continues the rate year 2021 reimbursement methods and standards for acute and critical access
inpatient hospital services for one month, and effective November 1, 2021, establishes comprehensive changes for the duration of rate year 2022.
Summary: Authorizes the state to enter in Value-Based Purchasing (VBP) rebate agreements with drug manufacturers for drugs provided under the Medicaid program. This SPA also allows the state to join a multi-state Preferred Drug List pool.
Summary: This amendment addresses third party liability and related Medicaid payments regarding medical support, prenatal care and pediatric services, described in attachment 4.22-B of Minnesota’s Medicaid State Plan.
Summary: Approved the State’s request to amend its State Plan to add a new 1915 Home and Community Based Services (HCBS) benefit. As part of the SPA, Illinois revised its 3.1-F pages, which authorizes Managed Care under 1932(a) to include the new 1915 program.