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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 exempts general acute care, reimbursed under the diagnosed related group (DRG) payment methodology, from continued stay service authorizations.
Summary: The purposed amendment will add the current process of implementing updated inpatient and outpatient hospital per diem rates published by the by Indian Health Services (IHS) in the Federal Register.
Summary: The addition of diagnosis-related groups and a new disproportionate share hospital (DSH) category; andRemoval of outdated language, grammar revisions, and updated organization structure.
Summary: This SPA updates the effective date and fee-schedules for Ambulatory Surgical Clinic Services, In-home Peritoneal Services, Physician Services, Licensed Behavior Analysts, Substance Use Rehabilitation Services, Personal Care Services, Personal Care Services for Community First Choice Option, Chore Services for Community First Choice Option, and Long Term Services and Supports (LTSS) Targeted Case Management.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind SPA AK-22-0014, which temporarily extended the flexibility of a 10% rate increase for providers of Title XIX HCBS services effective 4/30/23. Effective May 1, 2023, AK 23-0004, will permanently implement the 10% increase plus the rebased amount for each of the listed Title XIX state plan Home and Community-Based Services: personal care, targeted case management, and 1915(k) Community First Choice Services, which replaces the AK 23-0005 rescission amendment.
Summary: This State Plan Amendment implements a payment rate for providers of Home and Community Based Services adopting a 10% increase for all HCBS (including waiver) services.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow for a professional dispensing fee to be reimbursed no more than every 14-days per individual "medication strength".
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to increase pharmacy dispensing fees.
Summary: This submission complies with the American Rescue Plan (ARP) Act of 2021. ARP requires coverage of COVID-19 vaccines, testing, treatment, and treatment of a condition that could complicate the treatment of COVID-19 in Medicaid.
