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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: 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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase behavioral health reimbursement rates.
Summary: Provides for an inflationary rate increase of .25 percent for intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs).
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: With this amendment, the state will 1.) update conflict of interest (COI) standards to define provider shortage areas; 2.) clarify COI safeguards; 3.) update provider qualifications for Care Coordinators by clarifying providers must be at least 18 years old; 4.) update the quality improvement strategy; and 5.) update the non-medical transportation unit of service.
Summary: This amendment to amend the State Plan to include additional provider types for rehabilitative services and designates Licensed Professional Counselors as Other Licensed Practitioners
Summary: This is to amend the State Plan to change state plan page Attachment 2.6-A Page 26 to reflect that the state uses the maximum Community Spouse Resource standard permissible under federal law.