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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 revises the supplemental payment methodology to Nursing Facilities (NFs) for state fiscal year (SFY) 2022. Specifically, Idaho Medicaid will utilize a one-year NF Patient-Driven Payment Model (PDPM) Upper Payment Limit (UPL) methodology to distribute supplemental payments to qualifying providers.
Summary: This amendment will be modifying Wisconsin's payment methodology to nursing homes for COVID-19 Vaccines which are administered by skilled nursing facilities.
Summary: Effective January 1, 2021, this amendment updates the maximum amount allowed for the maintenance of a home for beneficiaries living in an institution to follow the Social Security Cost of living adjustment.
Summary: Modifies Wisconsin's methodology for payment by adjusting the reimbursement rate for nursing homes and intermediate care facilities for individuals with intellectual disabilities.
Summary: modifies the methodology in which nursing facilities (NFs) receive supplemental payment through their NF upper payment limit (UPL) supplemental payment program.
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the cap for supplemental disproportionate hospital share (DHS) payments to qualifying hospital providers.
Summary: Modifies inpatient and outpatient reimbursement rates,including for critical care supplements, wage area adjustment indices for border status hospitals, cost-to-charge ratios, and outpatient access payments effective January 1, 2020