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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 updates the state plan to reflect current policy for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs). Specifically, this amendment clarifies that ICF/IIDs, in addition to nursing facilities, are qualifying providers eligible to receive payments for reserved bed days while the ICF/IID resident is temporarily absent from the facility.
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 reimbursement for vaccine administration to $100 per dose in cases where vaccine administration is separately reimbursable at a fee amount.
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 authorize licensed nurses employed by home health agencies to administer COVID-19 vaccinations for individuals who: Have difficulty leaving the home to get the vaccine, or Are hard-to-reach due to specific reasons, and face challenges getting vaccinated.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to cover COVID-19 drug treatment provided through Emergency Use Authorization effective March 1, 2020, increase the rate for procedure code 36561 from Ambulatory Surgical Center (ASC) grouper3 to ASC grouper 10, effective August 26, 2021, and increase the reimbursement rate for administration of a COVID-19 vaccine effective September 1, 2021.
Summary: Changes the policy for reimbursement of child-serving residential facilities to include only facilities that are 16 or fewer beds and are exclusively for treatment purposes. This includes the new Qualified Residential Treatment Program (QRTP) license type and Substance Use Disorder (SUD) providers.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to extend the increased payments for nursing facilities and ICF/IIDs under Attachment 4.19-D to June 30, 2021.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to establish a July 2021 COVID-19 interim payment for primary care medical providers (PCMP) who provide integrated services. PCMPs who received a February 2021 (approved in TN 21-0003) or October 2020 COVID-19 interim payment (approved in TN 20-0035) are not eligible to receive the July 2021 COVID-19 interim payment.