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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 plan amendment is to extend the temporary rates for intermediate care facilities for individuals with intellectual disabilities (ICF/IID).
Summary: This plan amendment extends enhanced payments to private Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), in order to allow more time to address the needs of private ICF/IID that still rely on this variance while continuing to provide services to the residents of these facilities.
Summary: This plan amendment updates the provisions governing qualifying criteria and reimbursement methodology for other rural hospitals in order to increase payments for inpatient hospital services.
Summary: This plan amendment adopts provisions governing qualifying criteria and reimbursement methodology for other rural hospitals in order to increase payments for outpatient hospital services.
Summary: Effective November 20, 2024, this SPA amends the provisions governing the Pharmacy Benefits Management Program in order to align the language relative to vaccine administration and fees with CMS requirements.
Summary: This plan amendment updates the provisions governing qualifying criteria and reimbursement methodology for high Medicaid utilization academic hospitals in order to increase payments for inpatient hospital services.
Summary: The purpose of this SPA is to adopt provisions governing qualifying criteria and reimbursement methodology for high Medicaid utilization academic hospitals in order to increase payments for outpatient hospital services.
Summary: This plan amendment will pay a $12 direct care add‐on to private (non-state) owned intermediate care facilities for individuals with intellectual disabilities (ICF/IID) for increased costs related to retaining and hiring direct care staff.
Summary: This plan amendment edits the provisions governing reimbursement for hospice services in order to ensure that the current payment methodology aligns with CMS requirements.
Summary: The proposed SPA would reimburse the LSU Dental Ambulatory Surgical Center providers (ASC) similar or equivalent rate to the outpatient hospital surgery fee schedule rate.
