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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 changes the payment methodology for inpatient acute services to the All Patients Refined Diagnosis Related Groups (APR DRG) prospective payment system.
Summary: This State Plan Amendment makes a change to the State Plan to revise Medicaid reimbursement for inpatient or outpatient hospital services provided by a children's hospital located in a state bordering Indiana.
Summary: Updates the fee schedule methodology for EPSDT, Home Pharmacy Services, Medical Supplies, and Dental services in response to a Companion Letter issued by CMS with the approval of SPA 19-0005
Summary: Updates the Medicaid reimbursement rates for medical equipment (ME) and medical supplies HCPCS codes subject to the requirements of the 21st Century Cures Act of 2016.
Summary: makes changes to the MAGI-based income methodology in order to allow an alternative budgeting methodology for reasonable and predictable changes in income
Summary: This plan amendment implements the requirements of Section 1903(i)(27) of the Social Security Act concerning reimbursement for durable medical equipment.
