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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: Assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: an extension of our approved exception to establishing a recovery audit contractor. In 2019, CMS approved KY SPA 19-006, which approved an exception through April 1, 2022.
Summary: Allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment.
Summary: Designates Lisa Lee, Commissioner of the KY Department for Medicaid Services, as the Governor’s designee for review and approval of state plan amendments
Summary: This amendment designates Stephanie M. Bates, Acting Commissioner of the KY Department for Medicaid Services, as the Governor’s designee for review and approval of state plan amendments
Summary: To revise Kentucky's reimbursement to State University teaching hospital by providing an additional payment for the direct costs of graduate medical education.
