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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 amendment clarifies language regarding the assessment of penalties for late filing of a cost report and the removal of the requirement that there must be a change in the total per diem cost of the applicable cost center by ten cents or more per patient day in order to submit an amended cost report and changes to the intermediate care facility for the mentally retarded (ICF-MR) chart of accounts and the inclusion of day programming costs in the direct care costs of an ICF-MR.
Summary: This amendment modifies DSH reimbursement to add new criteria for qualification and modify the distribution by changing to a District specific formula that uses only uncompensated care related to District residents. This amendment also prescribes certain data reporting requirements for DSH facilities.
Summary: This deemed newborn plan amendment eliminates the restriction that a newborn, to remain Medicaid eligible, must return home from the hospital to live with the mother.