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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 is to modify its Medically Needy Income Levels and confirm the new income standards for its optional state supplement program, beneficiaries of which are eligible for Medicaid under Rhode Island's state plan.
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: Assure compliance with annual mandatory Health Home core set reporting for the State of New York. This reporting includes all quality measure data for measures on the Health Home Core Set.
Summary: Technical change to align with New York statute, which allows residents of Adult Care Facilities to receive both Hospice and Assisted Living Program services without having to disenroll from either, was originally approved on February 26, 2025.
Summary: For NYS CCO/HHs Serving Individuals with I/DD to assure compliance to submit annual mandatory Health Home core set reporting for the State of New York. This reporting includes all quality measure data for the Health Home Core Set measures.
Summary: This amendment proposes to extend the current exemption to the Recovery Audit Contractors (RACs) requirement to have a vendor that identifies and corrects improper Medicaid payments through the collection of overpayments and reimbursement of underpayments.
Summary: This amendment is for RI Opioid Treatment Program Health Home Services to comply with a federal State Health Official letter directing states to submit a SPA attesting to compliance with the CMS mandatory annual state reporting requirements for Health Home Core Set Measures for measuring and improving the quality of care delivered to Medicaid and CHIP beneficiaries.
Summary: This amendment is for CEDAR Health Homes to comply with a federal State Health Official letter directing states to submit a SPA attesting to compliance with the CMS mandatory annual state reporting requirements for Health Home Core Set Measures for measuring and improving the quality of care delivered to Medicaid and CHIP beneficiaries.