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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: Effective October 1, 2018, this amendment adds coverage of long term residential substance use disorder services, which would allow an individual to initiate and receive services to treat substance use disorders in a less intense care setting, to the state's alternative benefit plan (ABP).
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 temporarily modify the provider recertification process for providers of 1915(i) state plan HCBS. This amendment allows the state to align the state's processes with the state's 1915(c) HCBS and Appendix K submissions.
Summary: Effective January 1, 2021, this amendment updates the DSH program as well as inpatient hospital payments. Specifically, this (1) Updates the base year used to calculate the interim DSH payments and update the inflation rate used to trend the DSH base year cost; (2) expend 100% of its FFY 2021 allotment; (3) discontinue the normalization adjustment to the hospital specific DSH limits; (4) update the inflation rate used to trend the DSH base year cost to the end of the 2019 calendar year; (5) create separate DSH pools from the existing 2021 DSH allotment to be spread among rural hospitals. Additionally, South Carolina will (1) update the swing bed and administrative day rates based on the October 1, 2020 Nursing Facility Payment rate update; (2) update the long term per diem psychiatric hospital rates based on the FY2019 cost reporting period trended forward to the payment period; (3) provide for 100% retrospective cost settlement for all IP and OP services in rural hospitals.
Summary: This amendment proposes to add medication assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. This letter is to inform you that Michigan’s Medicaid SPA TN 21-0005 is approved effective October 1, 2020 until September 30, 2025, pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act.
Summary: Effective October 1, 2020, this amendment establishes coverage of the state's Certified Community Behavioral Health Centers' (CCBHCs) services and establishes payment rates.
Summary: Effective October 1, 2020 until September 30, 2025 and pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Summary: Effective July 1, 2021, this amendment revises the hospital auditing program to allow desk reviews/audits and focus reviews in lieu of on-site field audits. Current technology allows audits to be performed remotely instead of on-site or in-person.
Summary: Effective February 1, 2021, this amendment proposes to align Medicaid COVID-19 vaccine administration rates with Medicare rates and to allow other licensed practitioners such as pharmacists and pharmacy technicians to administer the COVID-19 vaccine.
