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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 extends coverage to members residing in a broader geographic area that qualify for Target Case Management (TCM) benefits for Integrated Care for Kids (InCK) in New Haven, Connecticut.
Summary: This amendment waives the requirement of issuing trauma code mailers for all ICD-9 and ICD-10 trauma codes to recipients when used on claims submitted with the agency that signify an accident may have occurred.
Summary: This amendment is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Home Health Core Set(s) of measures.
Summary: This amendment looks to enable recoveries of overpayments in the Medicaid State Plan. The Medicaid recovery audit contractors seek to increase the maximum allowable Medicaid contingency fee from 12.5 percent to 17.46 percent for all claim types.
Summary: This amendment is to reduce the income standard for the parents and caretaker relatives eligibility group from 155 percent of the federal poverty level to 133 percent of the federal poverty level.
