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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 amendment is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.
This SPA adds the newly expanded adult eligibility group as an included population and implements per member per month payments for eligible Indian Health Services (IHS), Tribal 638, Urban Indian Health, and Federally Qualified Health Centers/Rural Health Clinic (FQHC/RHC) facilities.
This SPA proposes to amend the language provisions for coverage of selective non-legend outpatient drugs. This SPA also updates additional Pharmacy coverage items on the State Plan pages.
This SPA proposes to update the excluded drug coverage language, as well clarify that for claims billed through the pharmacy point of sale system will be reimbursed using the reimbursement methodology found in Attachment 4.19-B for prescribed drugs.
Summary: This plan amendment the updates the Upper Payment Limit (UPL) program for private ground ambulance providers that provide 911 emergency transport services to Medicaid beneficiaries.
Summary: State is increasing the rates for the following 1915(i) services: peer support, family peer support, and training and supports for unpaid caregivers. Other revisions to the state plan include modifications to the requirements of care coordinators, individual provider qualifications for the housing support service, and the quality remediation process for quality measures in the state plan.
Summary: This SPA is to amend the provisions governing behavioral health rehabilitation services in order to remove the face-to-face requirement for Community Psychiatrics Support and Treatment (CPST) and to add permanent supportive housing agencies to the provider qualifications for Peer Support Services (PSS).
Summary: This SPA increased the hourly rate for agency providers by 1.6%, an expected weighted average increase of $0.56, decreased the hourly rate of Consumer Directed Employers (CDE) by 0.1%, an expected weighted average decrease of $0.04 and increased the mileage reimbursement to the Internal revenue Service (IRS) rate of $0.655 for 2023.
Summary: This plan updates the reimbursement methodology for clinic services and provides a rate increase for Children’s Behavioral Health Home-Based Rehabilitation Services.
Summary: This amendment align premium rates for the Working Healthy program with recent changes to the protected income level for Kansas Home- and Community-Based Services waivers, which eliminates premiums for most beneficiaries.