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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 for services on or after October 1, 2022, this amendment modifies the timeline of the Hospital Withhold Pay-for-Performance (HWP4P) program payments in the State Plan. HWP4P payments are made by the end of the
calendar year following the HWP4P measurement year.
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 a rate increase for providers of Personal Care Services (PCS) and Private Duty Nursing (PDN) services under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.
Summary: New Mexico is updating its State Plan. Language is being added to clarify that telehealth and teleconsultation services are reimbursed at the same rate as face-to-face visits.
Summary: Description: This SPA expands coverage to Children born to persons eligible for CHIP or the 1115 BadgerCare Reform waiver at the tome of birth.
Summary: With this amendment, the state is updating the SDPC pages of the State Plan to reflect the current practice of the department,
including language and role updates. There are no substantive changes to the program’s operations.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is split out payment for pasteurized donor human milk in inpatient settings in order to track utilization.
Summary: This amendment is to implement changes to state plan limits on amounts for necessary medical or remedial care to comply with 42 CFR 435.725(c)(4).