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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 case management services for the developmental disabled population via telephone for all four quarterly contacts in lieu of face-to-face contact for one of the quarterly contacts.
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 rescind the election of the COVID optional eligibility group.
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 update fees related to testing, prevention, and treatment of COVID-19. The multiple effective dates in the SPA and on the CMS-179 relate to the dates for the fee schedule date changes.
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 cover the new optional group for COVID testing.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment to 1) allow flexibility for mobile testing for COVID-19, and 2) provide expanded behavioral health services.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment to cover COVID-19 mobile testing.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. This second Medicaid Disaster Relief SPA for North Carolina includes temporary modifications to benefit and payment provisions during the emergency declaration period. The state is proposing the following temporary rate increases: 1) a 10% rate increase for certain providers facing a disproportionate impact during the pandemic, 2) a 5% general increase to all providers that have not yet received one as required by the State’s General Assembly, and 3) authority to provide payments to pharmacy providers for mail-prescriptions to reduce direct contact for beneficiaries and providers.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment to 1) allow Hospital Presumptive Eligibility (HPE) for individuals aged 65 and over who have income under 100% of the Federal Poverty Level, 2) eliminate copays for acute inpatient hospital stays for all members, and 3) eliminate cost sharing for all COVID-19 testing and treatment services.
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 cover the new optional group for COVID testing, expand coverage to certain 1915, 1915(k), home health, laboratory and telehealth services, adjust prior authorizations for medications, and increase certain payment rates.
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 make changes to eligibility, suspend most cost-sharing, adjust some existing benefits, expand telehealth flexibilities, and make certain payment changes.
