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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 eliminates the trend factor increase for inpatient hospital rates for calendar year 2012. It also sunsets the supplemental payments to certain hospitals that performed utilization reviews, since those are now performed for the State by a third party contractor.
Summary: This SPA updates the optional State supplement standards for special income level groups consistent with the published 2012 Federal poverty levels.
Summary: This amendment implements the consultation of tribal health programs prior to the submission of any plan amendment in compliance with Section 1902(a) (73) of the Social Security Act as required at 5006(e)(2) of the American Recovery and Reinvestment Act.
Summary: This SPA implement the CHIP Provider Screening and Enrollment provision under Section 6401 of the Affordable Care Act (the Act) and Section 1866(j)(2)(A) of the Act to establish procedures under which screening is conducted with respect to providers of medical or other forms of service under Medicare, Medicaid and CHIP.
Summary: This amendment requests an exception to the January 1, 2012, implementation date in regulation and requests a date of July 1, 2012, in order to allow time for the State to enter into a multi-state contract for selection of a Medicaid recovery audit contractor.
