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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 proposes to exclude tribal members’ primary residences or homesteads from Wisconsin’s definition of estate for the purposes of estate recovery in geographical areas where the Bureau of Indian Affairs provides financial assistance and social service programs.
Summary: This SPA amends to add coverage of routine patient costs associated with participation in qualifying clinical trials to conform with the new regulatory requirements of 1905(a)(30) and 1905(gg) of the Social Security Act (SSA).
Summary: This amendment provides attestation to coverage of usual and customary care for Wisconsin Medicaid beneficiaries participating in clinical trials as required by the Consolidated Appropriations Act of 2021 Effective January 1, 2022.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to increase payment rates to providers of personal care services (PCS) and private duty nursing (PDN) under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement targeted access supplemental payments for Safety-Net Care Pool (SNCP) hospitals.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow for hospitals to be reimbursed for nursing facility level of care in cases where the hospital is unable to find a nursing facility placement effective 12/1/21.
