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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 increases certain rates for physician, dental, podiatry, x-ray, lab, family planning, EPSDT, emergency ambulance, and home health services.
Summary: This plan amendment updates the definition of a safety net hospital and updates the Acuity Adjustment Payment and Stop Loss Payment methodologies.
Summary: This state plan amendment incentivizes DD TCM staff to complete the Person-Centered Thinking (PCT) and the Fatal Five for Case Managers training to improve the quality of care and quality of life for individuals with developmental disabilities.
Summary: This State Plan Amendment is adding back language related to final DSH redistributions and adding language regarding final DSH redistributions and unspent allotment payments to bankrupt-liquidation and closed hospitals.
Summary: The State provides for coverage of a maximum of twelve reserve bed days for the first six calendar months and 12 days for the second six calendar months of the year for recipient residents of Title XIX nursing facilities for the purpose of therapeutic home visits. The absence must be specifically provided for in the patient's plan of care and physician prescribed.
