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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 Nevada SPA 21-0012 was approved on July 7, 2022 inadvertently omitted Attachment 4.19-B, Pages 3a and 3a (Continued). We have attached these pages as well as a revised CMS-179 that reflects their inclusion in the approval. No other SPA pages are affected, and the original SPA approval date of July 7, 2022 and effective date of August 27, 2021 remain in effect for the entire SPA, including the two omitted pages.
Summary: This amendment complies with the requirements for assurance of Medicaid coverage for non-emergency medically-related transportation in accordance with Section 209 of the Consolidated Appropriations Act of 2021.
Summary: Adjust the reimbursement methodology for nursing facilities to align with the Medicare Patient Driven Payment Model (PDPM), incentivize quality care and staffing levels, and include a $70 million annual quality incentive payment tied to Long Stay STAR ratings.
Summary: To update State Plan language regarding the EPSDT program, including eligible provider types, clarifying limitations to dental and audiological services, and removing references to the 504 Written Individualized Program.
Summary: upgrades the version of Enhanced Ambulatory Patient Group (EAPGs) in use for calculation of fee for service outpatient hospital payment in order to align payment with modern outpatient healthcare delivery standards.
Summary: Updates the payment methodologies for the Outpatient Disproportionate Share Hospital (OP DSH) and Outpatient Small and Rural Hospital (OP SRH) supplemental reimbursement programs.
Summary: Provides additional reimbursement to nursing facilities for increases in costs associated with staffing, supplies, social distancing standards, and other factors due to the COVID-19 national emergency.
Summary: This amendment is to allow licensed clinical professional counselors and licensed marriage and family therapists to enroll in Medicaid and bill fee-for-service.