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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 to respond to the COVID-19 national emergency. The purpose of this amendment is to provide incentive payments to residential facilities to encourage discharges from hospitals.
Summary: This SPA clarifies that all vaccine administration services are paid at a rate of $4.00 unless otherwise specified, regardless of billing code. This SPA also sets the state's Monkey Pox vaccine administration rate equal to the Medicare geographic rate for COVID-19 vaccine administration, updating the effective date to 10/15/22 and the fee schedule links for Evaluation & Management Services (E&M) and vaccine administration.
Summary: This amendment updates the Alternative Benefit Plan (ABP) pages to align with the addition of the mandatory benefit that covers routine patient costs associated with participation in qualifying clinical trials approved in SPA 22-0004.
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 implement new rate models for most Office of Developmental Disabilities Services (ODDS) providers.
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 extend the 5% increase in payment rates for Office of Developmental Disabilities Services and settings for the period 10/1/22 through 12/31/22 or until the end of the PHE whichever is first.
Summary: This amendment removes the designations for Prepaid Inpatient Health Plan (PIHP) and Prepaid Ambulatory Health Plan (PAHP) from the state's Alternative Benefit Plan (ABP).
Summary: This amendment is to remove the designations for Prepaid Inpatient Health Plan (PIHP) and Prepaid Ambulatory Health Plan (PAHP) from the State Plan.
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 provide a temporary rate increase for nursing facilities, assisted living facilities, and residential care facilities.
Summary: This SPA increased the fee-for-service reimbursement behavioral health rates by an aggregate average of 30 percent and also removed interpreter services from this page as interpreter services are approved for all programs under TN 22-0009.
