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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: Medicaid coverage of ce1tain medical transpo1tation. It attests that all the minimum requirements outlined in 1902(a)(87) of the Social Security Act are met.
Summary: Revises the minimum requirements for Targeted Case Management case managers to include a bachelor's degree, or five (5) years of relevant experience in the field of long tenn services and suppo1is (which includes developmental disabilities), or some combination of education and experience appropriate to the requirements of the position.
Summary: adds clarifying language specific in how Graduate Medical Education (GME) payments are made to hospitals for inpatient and outpatient hospital services provided to Medicaid managed care clients.
Summary: Updates the outpatient pharmacy rate methodology for blood clotting factor drugs by incorporating Average Acquisition Cost (AAC) and Clotting Factor Maximum Allowable Cost (CFMAC) rates, along with a $0.03/unit enhanced professional dispensing fee.
Summary: This amendment aligns the home health services rule with the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act, and federal regulation, by adding nurse practitioners, clinical nurse specialists, and physician assistants to the list of practitioners who can order home health services.
Summary: Updates the payment amount for the University of Colorado School of Medicine Supplemental Payment for Physician and Professional Services at qualifying Colorado State-Owned or Operated Professional Services Practices.
