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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: By means of this SPA, New Jersey brings its State Plan into compliance with Section 1903(r) of the Act and 42 CFR 435.960, which requires States to have an eligibility determination system that provides data matching with other State's medical assistance systems through the Public Assistance Reporting Information System (PARIS). New Jersey began using PARIS in 2008.
Summary: This SPA amends Idaho's current 1915(i) State plan benefit by adding clarifying language to the services available to eligible participants. In addition, this SPA adds language to indicate that on June 30, 2013, Intensive Behavioral Intervention (IBI), IBI consultation, Developmental Therapy (DT), and Children's Service Coordination (CSC) will sunset in Idaho's Basic and Enhanced Benchmark Benefit plans.
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 implements the Medicaid/CHIP Provider Screening and Enrollment provision under section 6401 of the Affordable Care 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: his SPA reduces the amount, duration and scope of dental services available to individuals over the age of twenty-one, limiting the dental benefit package to emergency and medically necessary oral surgery and palliative services and associated diagnostic services. The benefit changes apply to non-pregnant adults over the age of twenty-one (21), who are eligible for Medicaid's Basic or Enhanced plans.
Summary: Under this SPA, Idaho is adding certain services to comply with Section 41 07 of the Patient Protection and Affordable Care Act to provide for Medicaid coverage of comprehensive tobacco cessation services for pregnant women, including both counseling and pharmacotherapy, without cost sharing.
