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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: Proposes to apply the reimbursement methodology for inpatient and outpatient hospital services for State fiscal year 2020 in a manner consistent with that used in fiscal year 2019
Summary: Allows Targeted Case Management (TCM) providers in targeted groups 2, 3, and 10 who are Regional Boards to provide services directly or through a contract
Summary: This SPA allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities ACT (P.L. 115-271).
Summary: Proposes to allow the Alabama Medicaid Agency to enter into value/outcome(s) based agreements with drug manufacturers for purpose of collecting additional supplemental drug rebates
Summary: Amends the reimbursement methodology with an Alternative Payment Methodology (APM) allowing Federally Qualified Health Centers (FQHC) to be eligible for performance payments if the FQHC meets the requirements outlined in the in the Alabama coordinated Health Network (ACHN) program as defined in the ACHN (AL-09) 1915(b) waiver.
Summary: Amends the reimbursement methodology with an Alternative Payment Methodology (APM) allowing Rural Health Clinics (RHC) to be eligible for performance payments if the RHC meets the requirements outlined in the in the Alabama coordinated Health Network (ACHN) program as defined in the ACHN (AL-09) 1915(b) waiver.
