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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is split out payment for pasteurized donor human milk in inpatient settings in order to track utilization.
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: Effective January 31, 2021, this amendment modifies rates payable to Indian Health Services and eligible tribal health facilities operating under Public Law (P.L.) 93-638.
Summary: Effective January 01, 2021, this amendment adds substance use disorder (SUD) as an additional eligibility criterion for Health Home Services. For payments made to Health Homes providers for Health Homes participants who newly qualify based on the Health Homes program’s additional condition coverage under this amendment, a medical assistance percentage (FMAP) rate of 90% applies to such payments for 8 quarters from the effective date of this SPA. The FMAP rate for payments made to health homes providers will return to the state's published FMAP rate at the end of the enhanced match period.
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 add pharmacists, pharmacy interns, pharmacy technicians, and pharmacies as qualified providers of COVID-19 vaccinations and to implement reimbursement for the COVID-19 vaccine administration.
Summary: Updates DRG rates for inpatient hospital services for Intensive Care Unit inpatient hospital stays as well as all other inpatient hospital stays
