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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 proposes to extend the current exemption to the Recovery Audit Contractors (RACs) requirements to have a vendor that identifies and corrects improper Medicaid payments through the collection of overpayments and reimbursement of underpayments from August 5, 2022, to August 4, 2024.
Summary: With this amendment, the state is updating the professional qualified to submit a statement of need for services. CMS supports approval of this amendment as it will not have a negative beneficiary impact, is consistent with Medicaid statutory requirements, regulations, and policies and permits the state to make systemic changes to allow them to administer the program as they desire.
Summary: Updating the Opioid Health Home to reflect the current Opioid Heath Home (OHH) to optimize and expand the OHH in select Michigan Counties. The specific counties include: Arenac, Barry, Bay, Berrien, Branch, Cass, Clare, Clinton, Eaton, Gladwin, Gratiot, Hillsdale, Huron, Ingham, Ionia, Isabella, Mecosta, Midland, Montcalm, Newaygo, Oakland, Osceola, Saginaw, Shiawassee, St. Joseph, Tuscola, and Van Buren.
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 adjust incontinence supply competitive bid 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 rescind the establishment of the COVID laboratory testing reimbursement rate at 100% of Medicare that was approved on June 18, 2020 under SPA NV-20-0009.
Summary: This SPA provides Georgia with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This SPA provides Pennsylvania with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.