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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: Effective October 1, 2020, this amendment adds the new mandatory MAT benefit 1905 (a)(29) in compliance with section 106(b) of the SUPPORT Act. MAT services include all FDA-approved or licensed drugs and biologicals to treat opioid use disorder (OUD), counseling services and behavioral therapy. These MAT services will provide necessary treatment for Medicaid beneficiaries with OUD and help address the national opioid epidemic.
Summary: Effective April 1, 2021, this amendment adds the optional eligibility group described at section 1902(a)(19)(A)(ii)(XXII) of the Social Security Act to the Alabama state Medicaid plan (the "Individuals Receiving State Plan Home and Community-Based Services group," or "219(a) group").
Summary: Updates the Alabama Coordinated Health Network (ACHN) Quality Bonus Payment date from July 2021 to October 2021, effective March 1, 2021. The reason for the change is to allow enough run time for historical claims data.
Summary: This amendment will allow for Case Management Services to be billed for High Intensity Care Coordination for each eligible recipient in the family, each month, according to each recipient’s unique needs.
Summary: Effective July 1, 2020, this amendment allows the disregard of Census-based income for certain Non-Modified Adjusted Gross Income (non-MAGI) eligibility groups.
Summary: Effective July 1, 2020, this amendment increases the number of FTEs for the states Graduate Medical Education (GME) program which will provide access to care in more rural areas of the state. Both public and private hospitals will be allowed to participate.
Summary: This SPA incorporates the current version of the Program of All-Inclusive Care for the Elderly (PACE) State Plan Amendment preprint and provide State assurances that PACE rates are set at less than 100% of the amount that would otherwise have been paid for a comparable population.
Summary: Effective March 1, 2021, this amendment implements a new reimbursement methodology for all Indian Health Services and Tribal 638 pharmacy facilities based on the All-Inclusive Rate (AIR).
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.