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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: The state proposes to include an assurance that the state covers routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials.
Summary: Effective January 14, 2022, this amendment authorizes a one-time $30,000,000 supplemental Charity Care Subsidy Disproportionate Share Hospital (DSH) payment. Consequently, the total Charity Care Subsidy payments for state fiscal year (SFY) 2022 increases to $349,000,000.
Summary: To incorporate additions to the benefits and payment state plan pages in order to implement the Center for Medicare & Medicaid Innovation's (CMMI) Integrated Care for Kids (InCK) ModeL a child-centered local service delivery and state payment model The state will limit implementation of the InCK Model to two counties in the state utilizing CMMI waiver authority in section 1115A(d)(1) of the Social Security Act. The CMMI waiver authority is applicable only while the New Jersey InCK Model is implemented in accordance with the InCK Model's Terms and Conditions of Award.
Summary: Suspends the Medicaid Recovery Audit Contractor Program, a requirement in section 1902(a)(42)(B)(i) of the Social Security Act, for a two year-year period because ninety-seven percent of Medicaid beneficiaries participate in managed care.
Summary: This amendment proposes to include an attestation that the state provides non-emergency medical transportation (NEMT) services consistent with the provisions outlined in the Consolidated Appropriations Act, 2021.
