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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: To transition the New York State Medicaid non-emergency medical transportation (NEMT) program from an administrative- services only model to a risk-based broker model authorized pursuant to Section 1902(a)(70) of the Social Security Act.
Summary: To revise the State Plan to expand coverage of store and forward services for the purposes of strengthening and sustaining telehealth as a high-quality, cost effective, and consumer-oriented form of care delivery.
Summary: This plan proposes updates to Ambulatory Patient Group (APG) rates for freestanding clinics and reimbursement for Licensed Mental Health Counselors (LMHCs) services and Licensed Marriage and Family Therapists (LMFTs) services.
Summary: Attached for your review and approval is the Original Submission of NY SPA 22-0056 (ELIMINATE 1.5% NH RATE REDUCTION), along with evidence of tribal consultation
Summary: This plan proposes to establish an Alternative Payment Methodology (APM) for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
Summary: To expand Applied Behavior Analysis services provided by New York State Licensed Behavior Analysts to all Medicaid eligible individuals, regardless of age, as the current State Plan limits Applied Behavior Analysis services to individuals under 21 years of age.
Summary: This plan amendment will update payment for physician-administered drugs. It will also allow the Department of Health Care Finance to reimburse the entire class of physician-administered drugs at one hundred percent (100%) of Medicare rates.
Summary: This amendment proposes to revise the State Plan to assist safety net hospitals by providing a temporary rate adjustment under the closure, merger, consolidation, acquisition, or restructuring of a health care provider.
