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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 SPA proposes to suspend the Medicaid Recovery Audit Contractor Program, a requirement in section 1902(a)(42)(B)(i) of the Social Security Act, for a two-year period because ninety-seven percent of Medicaid beneficiaries participate in managed care.
Summary: This amendment is to discontinue the Recovery Audit Contractor (RAC) program. These changes are being made due to the State having a high managed care population at 83% compared to 17% Fee for Services; therefore, the state does not project any large recoveries in the future for the RAC program.
Summary: Suspends the Medicaid Recovery Audit Contractor Program, a requirement in section 1902(a)(42)(B)(i) of the Social Security Act, for a two year-year period because ninety-seven percent of Medicaid beneficiaries participate in managed care.
Summary: proposes to update the language pertaining to the admission review for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).
