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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 continues a per diem increase of $2.09 for nursing facility and HIV nursing facility services that was due to expire on June 30, 2016. This SPA also provides for an addition per diem increase of $2.83 for these services beginning July 1, 2016.
Summary: This amendment modifies the State's Disproportionate Share Hospital payment methodology. The annual DSH survey process is updated, a provision is added for extraordinary circumstances and the interim payment process is adjusted. Final DSH payments due to providers are not affected by this SPA.
Summary: Provides for a one percent increase in per diem rates for private Intermediate Care Facility for Individuals with Intellectual Disabilities services.
Summary: Amends the provisions governing Early and Periodic Screening Diagnosis, and Treatment Services to include Applied Behavior Analysis Services for individuals under age 21 with Autism Spectrum Disorder.
Summary: This amendment clarifies the authority and responsibilities of the Single State Agency and its relationship to other federal and state agencies, the fair hearing process, and the process for determining eligibility.
Summary: Describes the groups who are determined eligible using Modified Adjusted Gross Income (MAGI) in accordance with the Affordable Care Act (ACA).
