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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 issuing a technical correction to the approval package for TX-22-0028. TX-22-0028 introduced Page 1 of Supplement 5 to attachment 4.19-B as a NEW page, however a previously approved SPA already added Page 1 of Supplement 5 to attachment 4.19-B. This technical correction will make the page added by TN 22-0028 Page 1-a.
Summary: Provides authority for coverage and payment of targeted case management for individuals age 18 and older who meet Medicaid eligibility requirements, have a chronic or complex physical or behavioral health need, and were recently incarcerated.
Summary: This plan amendment allows for a technical adjustment, noting that physician-administered drugs are paid at the Medicare drug fee schedule rate, rather than the average sales price + 6% if the drug is listed on the Medicare drug fee schedule.
Summary: This amendment updates the requirements in the Medicaid State Plan for licensed mental health professionals who provide outpatient mental health services to clients eighteen years of age and younger.
Summary: This State Plan Amendment (SPA) revises the reimbursement for FQHC and RHC providers to pay for long acting
reversible contraception devices separately from the prospective payment system.