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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: 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 align the Expansion Adult ABP with previously approved Disaster Relief SPAs.
Summary: This state plan amendment amends the reimbursement methodology for federally qualified health centers (FQHC) to separate reimbursement for long-acting reversible contraceptive (LARC) devices from the encounter rate.
Summary: Effective the day after the Public Health Emergency (PHE) ends, this amendment revises the providers that can order home health services. In addition to physicians, the amendment allows nurse practitioners, clinical nurse specialists, or physician assistants, working in accordance with State law, to order home health services to comply with federal regulation.
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 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: Effective September 1, 2021, this amendment modifies the Other Licensed practitioner benefit to allow licensed psychologists to render applied behavior analysis (ABA) services within state scope of practice without previous ABA related national certification requirements. This action will allow additional state licensed psychologists to provide services within state scope of practice, permissible under the OLP benefit and will likely increase the provider pool, which would be beneficial to Medicaid eligible children with autism.
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 allow a temporary supplemental payment for long-term care facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) to support increased costs due to COVID-19.
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.