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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 update amends the provisions governing leave of absence days during a federal public health emergency declared by the Secretary of Health and Human Services.
Summary: Effective 02/01/2021, this update amends the provisions governing adult mental health services in order to add peer support services as a covered rehabilitative service.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this SPA is to waive or modify certain requirements of Title XIX of the Act to address the COVID-19 public health emergency, in order to provide a one-time lump sum payment to privately owned and operated intermediate care facilities (ICF) for individuals with intellectual disabilities (IID), and a one-time lump sum payment for Long Term Personal Care Services providers.
Summary: The Louisiana Department of Health, Bureau of Health Services Financing proposes to amend the provisions governing the reimbursement methodology for nursing facilities in order to increase the allowable square footage for calculating payments when a Medicaid participating nursing facility has at least 15 percent of its licensed beds in private rooms
Summary: This state plan amendment is to amend the provisions governing hospice services provided concurrently with life-prolonging treatments to individuals under age 21 in order to update existing terminology and reflect current practices, and to comply with federal requirements which allow for pediatric concurrent care
Summary: Amends the provisions governing reimbursement for non-state intermediate care facilities for persons with intellectual disabilities (ICFs/IID) to increase the reimbursement rates to facilities that downsized from over 100 beds to less than 35 beds prior to December 31, 2010, without the benefit of a cooperative endeavor agreement.
Summary: The purpose of this SPA is to amend the provisions governing reimbursement for end stage renal disease (ESRD) facilities in order to allow contracted independent laboratories to bill the Medicaid program directly for the provision of covered non-routine laboratory services instead of receiving reimbursement from the ESRD facility
Summary: Amendment is to modify third party liability (TPL) rules related to special treatment of certain types of care and payment and to allow for payment up to 100 days after a claim is submitted for claims related to support enforcement; to modify TPL rules around preventive pediatric services; and to modify the cost avoidance changes for prenatal services and coordination of benefits cost avoidance when processing claims for prenatal services, including labor and delivery, and postpartum care claims.
