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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 SPA updates the definition and criteria for Nominal Charge Providers and updates MO Health Net fee schedules for outpatient reimbursement when a Medicare rate is not available.
Summary: Increases rates to services provided by Psychiatric Rehabilitation Services provided by Community Mental Health Centers and Independent Clinics (except for Federally Qualified Health Centers (FQHCs)), Ambulatory Surgical Centers, Medicaid Children’s Clinics, Public Health Clinics, and Planned Parenthood Clinics. Based upon the information provided by the State
Summary: This Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) plan amendment implements an updated Medicaid Youth Mental Health Fee Schedule, reflecting updated reimbursement rates.
Summary: This plan amendment increases the rate and conversion factor to reflect the 2021 legislative appropriation of 1.9% increase and add the service to the state’s reimbursement Introduction Page, as it pertains to Targeted Case Management for Individuals with Developmental Disabilities Enrolled in the 0208 1915(c) Comprehensive Waiver or Eligible Individuals Age 16 and Over.
Summary: The purpose of this amendment is to temporarily increase payment rates for fee for service state plan home and community based services through quarterly supplemental payments based upon a percentage of Medicaid allowable paid claims in order to maintain a stable workforce and preserve services during the declared public health emergency.
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 implement an incremental increase to the current Urban Indian Organization (UIO) Prospective Payment System (PPS) rates effective July 1, 2021, through the duration of the Public Health Emergency (PHE).
Summary: This SPA authorizes coverage and reimbursement of COVID-19 vaccine and vaccine administration, in compliance with the American Rescue Plan (ARP) Act of 2021.