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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 proposes to increase the reimbursement rate for all vaccine administration services for both pediatrics and adults and to clarify and consolidate the payment parameters for vaccine administration.
Summary: This plan amendment updates the rate methodology for the 1915 Home and Community Based Services (HCBS) Community Mental Health Wraparound (CMHW) services to align with other HCBS program methodology.
Summary: This plan amendment proposes to makes changes to the SPA to revise the Medicaid reimbursement for physician services which will be reimbursed utilizing the Medicare payment policies for practitioner payment reductions and site-of-service payment reductions under the Medicare physician fee schedule.
Summary: Hawaii MQD rebasing NF rates and changing the case mix from using the RUGs system to the Patient Driven Payment Model system (PDPM). The change is required because CMS has changed to PDPM and will no longer be supporting the RUGs system
Summary: This State Plan Amendment (SPA) proposes to revise Medicaid reimbursement rates for medical supplies and medical equipment that are not subject to the requirements of the 21st Century Cures Act of 2016 as codified at Section 1903 (i)(27) of the Social Security Act.
Summary: This State Plan Amendment (SPA) proposes to makes changes to the Medicaid State Plan to establish Medicaid reimbursement rates for applied behavior analysis (ABA) therapy services.
Summary: This State Plan Amendment (SPA) proposes to increase payment up to Medicare benchmark for most medical professional, non-institutional items and services.
Summary: This State Plan Amendment (SPA) proposes to make changes to the Medicaid State Plan to revise Medicaid reimbursement rates for physician and other practitioner services, including reimbursement rates for physician, anesthesiology, and dental services.
