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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: This plan amendment updates the date of the fee schedule to implement a revised fee schedule, dated January 1, 2021, which reflects an updated reimbursement rate for Home Support Services (HSS). The revised fee schedule also reflects an updated reimbursement rate for Comprehensive School and Community Treatment (CSCT).
Summary: revises the coverage location of Applied Behavior Analysis (ABA) services in the state plan, clarifies that ABA services are provided for individuals under the age of 21 pursuant to EPSDT, clarifies the qualified practitioners that can furnish ABA services in Montana, and makes conforming changes to the corresponding reimbursement pages.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to add an Intensive Outpatient rehabilitation benefit for youth with serious emotional disturbance (SED).
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to temporarily increase payment rates for state plan home and community-based services through quarterly supplemental payments based upon a percentage of Medicaid allowable paid claims in order to maintain a stable workforce and preserve services during the declared public health emergency.
Summary: Updates the bundled composite rate for services provided in an outpatient maintenance dialysis clinic. The Dialysis Clinic reimbursement rate will be increased by 1%.
Summary: Revises the description of the non-federal share for Comprehensive School and Community Treatment (CSCT) and updating the EPSDT fee schedule to reflect a 1.83% provider increase.
Summary: Updates the bundled composite rate for services provided in an outpatient maintenance dialysis clinic. The Dialysis Clinic reimbursement rate will be increased 1.83% per legislative appropriation.
Summary: Effective April 1, 2021, this amendment adds Licensed Marriage and Family Therapists to the approved Other Licensed Practitioners (OLP) in the state plan, including as recognized licensed OLP Dually Licensed Practitioners. In addition, this amendment adds a reimbursement methodology for Licensed Marriage and Family Therapist practitioner and updates the existing OLP benefit pages.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow the territory to consider individuals absent from the territory to continue to be residents; to provide rate increases for FQHC medical encounters rendered at government quarantine locations; to create payment methodology for local non-government dialysis centers in AS during the PHE period; to revise the payment methodology for off-island dialysis; and to revise payment methodology for transportation and related accommodations associated with return from off-island medical care.
