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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 move away from cost-based reimbursement for Accredited Residential Treatment Centers for Adults with Substance Use Disorders (AARTCs) services and instead proposes a prospective fee schedule system.
Summary: This plan amendment allows hospitals to be reimbursed for implementing a plan of care for infants in the Comprehensive Addiction Recovery Act (CARA) program separate from the DRG.
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: 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.
