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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: Will allow a physician assistant (PA), certified nurse practitioner (CNP), and clinical nurse specialist (CNS), to the extent allowed by Texas state licensure, to certify eligibility for home health services, as well as establish and periodically review the home health plan of care.
Summary: Ensures that the Texas Medicaid State Plan complies with the Bipartisan Budget Act (BBA) of 2018 and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019, affecting the BBA of 2013, that modified third party
liability (TPL) requirements related to special treatment of certain types of care and payment.
Summary: Clarifies that, to the extent required by EPSDT, a licensed behavior analyst (LBA) operating within the LBA’s state scope of practice and licensure requirements may provide applied behavior analysis (ABA) evaluation and treatment services to children under 21 who have a diagnosis of autism spectrum disorder (ASD).