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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 plan amendment will permit the District's Medicaid program to provide supplemental payments in Fiscal Year 2024 to Medicaid-enrolled physician groups, with at least five hundred (500) physicians and that contract with a public general hospital located in an economically under-served area of the District to deliver inpatient, emergency department, and intensive care physician services to Medicaid beneficiaries.
Summary: This amendment increases the per diem rate for private Psychiatric Residential Treatment Facilities (PRTFs) to $792.46 for additional costs of adding director of nursing staffing to improve the quality and oversight of services.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to authorize temporary extensions of increases to the personal needs allowance for certain beneficiaries, a delay in rebasing rates for federally qualified health centers and specialty hospitals, reimbursement rate increases for certain facilities and services, and modifications to the District’s health home program.
Summary: This SPA is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that
Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This plan updates the reimbursement methodology for clinic services and provides a rate increase for Children’s Behavioral Health Home-Based Rehabilitation Services.
Summary: This plan updates the reimbursement methodology for Physician Services, Laboratory Services, Medical Equipment, Devices and Supplies (MEDS), Dental, and Independent Radiology Services.
Summary: To adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
