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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 add the populations served by the following 1915(c) HCBS waivers as target groups for Targeted
Case Management: Brain Injury (BI), Children's Home and Community Based Services (CHCBS),Children with Life Limiting Illness (CLLI) Complementary and Integrative Health (CIH), Community Mental Health Supports (CMHS), and Elderly, Blind, and Disabled (EBD).
Summary: This amendment expands school-based health services (SBHS) under the Rehab benefit by 1) adding specialized transportation to school-based rehabilitative services and 2) increases reimbursement for students covered under the Individuals withDisabilities Education Act (IDEA). The SPA also introduces a new reimbursement methodology for SBHS.
Summary: The purpose of the amendment is to change the minimum qualification for service coordinators to match proposed revisions recommended to state rule. HHSC is amending the minimum hiring qualifications for service coordinators (also referred to as case managers in the state plan) that work for LIDDAs throughout Texas.
Summary: This amendment is to add coverage and reimbursement of community violence prevention services performed by certified violence prevention professionals as a new benefit within the preventive services benefit category.
Summary: This amendment expands school-based health services (SBHS) under the Rehab benefit with the following services: 1) school health aide service; 2) developmental rehabilitative therapy (enhances existing service); 3) specialized transportation. The SPA also introduces a new reimbursement methodology for SBHS.
Summary: This amendment is to update the definition of a visit to include telehealth services in Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal Health programs and adds associate marriage and family therapists (AMFTs) and associate clinical social workers (ACSWs) in FQHCs and RHCs.
Summary: This amendment modifies the eligibility criteria for Ohio’s Comprehensive Primary Care (CPC) program to prevent duplication of payments for CPC services and the new Comprehensive Maternal Care program services. This SPA also re-aligns quality metrics to reflect accurate industry terminology.
Summary: Implements the Comprehensive Maternal Care (CMC) program, which is a comprehensive care coordination and service model incorporating supportive care for expectant and postpartum individuals.