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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: This increases the Medicaid per diem rate for facilities with more than 16 licensed beds licensed by the Department of Public Health under the ID/DD Community Care Act located in the Department of Public Health's Planning Area 7-B.
Summary: This increases the reimbursement rate for facilities licensed by the Department of Public Health under the ID/DD Community Care Act as an ID/DD facility and medically complex for the developmentally disabled facilities licensed under the MC/DD Act.
Summary: Amendment clarifies reimbursement for out-of-state hospitals be the lesser of charges or the home state's reimbursement, with the exception of District hospitals.
Summary: To allow the Mississippi Division of Medicaid to provide a written request for the renewal of the 1915(i) state plan services due to expire October 31, 2018, to align the 1915 (i) CSP service rates with those of the ID/DD waiver to ensure access, and to comply with the Home and Community Based settings final rule.
Summary: Adjustments to nursing home rates in State Fiscal Year (SFY) 2018 and SFY 2019. The first adjustment restores the funding that was removed from the rate in SFY 2017 due to the expiration of fair rent. The second rate adjustment freezes SFY 2018 and SFY 2019 nursing home rates in the aggregate while re basing SFY 2018 nursing home rates, providing a downside stop loss of 1.6%. The final adjustment allows for new fair rent additions in SFY 2018 and SFY 2019 based on assets placed into service in SFY 2016 and SFY 2017, respectively.
Summary: This allows allows the California Department of Health Care Services (DHCS) to sunset the current one percent payment reduction applicable to Home Health Agency (HHA) services and to increase reimbursement rates by 50 percent for state plan HHA services and certain Pediatric Day Health Center (PDHC) services.
Summary: Requirements for (1) a face-to-face visit with a physician or authorized non-physician practitioner prior to the initiation of home health visits or provisions of durable medical equipment (DME) and appliances, (2) the provision of home health services in any setting which normal life activities take place, and (3) revises the definition of DME to comply with the Medicaid Home Health Final Rule.
Summary: This updates the home health professional services; durable medical equipment, prosthetics, orthotics and supplies; hearing aids and audiometric evaluations; and vision care services fee schedules.