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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: Amends the provisions governing adult behavioral health services in order to provide Medicaid coverage and reimbursement for licensed mental health professional services and mental health rehabilitative services to adult members enrolled in Bayou Health and terminates the behavioral health services rendered under the 1915(i) State plan authority.
Summary: Describes the methodology used by the state for determining the appropriate Federal Medical Assistance Payment rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state.
Summary: Amends the provisions governing therapeutic group homes in order to: revise the terminology to be consistent with current program operations and revises the reimbursement methodology to establish capitation payments to managed care organizations for children's services.
Summary: Changes the provisions governing school based health services in order to transition these services out of managed care and into the group of school based Medicaid services provided by Local Education Agencies.
Summary: To amend the provisions in the LA Medicaid State Plan governing Federally Facilitated Marketplace eligibility determinations to become an "assessment" state and only accept eligibility accessment from the FFM rather than accepting Medicaid eligibility determinations made by the FFM.
Summary: Amends the provisions governing managed care for physical and basic behavioral health in order to transition behavioral health services from administration by a single statewide management organization to an integrated behavioral and physical health model which will be administered by the five Bayou Health managed care organizations.
Summary: Provisions for governing coordinated care network and Medicaid managed care in order to change the name and to incorporate programmatic changes resulting from the inclusion of basic behavioral health services in the program and the voluntary enrollment of Medicaid eligible children identified in the Melanie Chisholm.