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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 rescinds temporary disaster relief provisions of the state plan to allow the agency to make American Rescue Plan Act Section 9817 increases for home and community-based services by Provider Types 29, 30, 39 and 83.
Summary: To remove the expiration date from PR SPA 21-0012 and modify the income disregard for certain categorically needy and medically needy eligibility groups in the Puerto Rico Medicaid program.
Summary: This amendment modifies the methodology for determining payment rates for targeted case management services. The amendment also provides assurances regarding case management services for institutionalized individuals, and includes one technical correction regarding the comparability of services.
Summary: To remove the expiration date from PR SPA 21-0011 and add language to keep the Puerto Rico Local Poverty Level at 85 percent of the federal poverty level.
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 allow administration of COVID-19 therapies and treatments by licensed paramedics within the scope of their practice as defined under State law.
Summary: This amendment is to increase the excess home equity limit to the federal maximum allowed amount when determining a person’s eligibility for SSI-related long-term care (LTC) services as described in WAC 182-513-1350.