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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 was submitted in order to update the Medicaid fee schedule to include the rate increase for adaptive behavioral treatment by Behavioral Therapists.
Summary: This amendment is comply with new mandatory Medicaid coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials.
To amend the coverage of lactation counseling services for pregnant and post-partum women by expanding the list of those able to provide lactation services in accordance with Social Services Law 365-a(x)(i).
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 increase the daily per diem rate paid to privately owned or operated nursing facilities and include a direct care add-on to reimburse ICF-IID for increased cost related to retaining and hiring direct care staff.
Summary: Allows the Current Dental Terminology (CDT) dental codes to be updated from the CDT 2021 (“CDT-21”) code set to the CDT 2022 (“CDT-22”) code set for the purpose of dental service reimbursement.
Summary: Updates the 12-month cap period, beginning on October 1 of each year and ending on September 30 of the following year for hospice care reimbursement.
This plan amendment proposes a one percent cost of living adjustment for noninstitutional services, day treatment, clinic services, and independent practitioner services for individuals with developmental disabilities (IPSIDD).
Summary: This amendment is to comply with coverage of routine patient costs for services and items provided to Medicaid beneficiaries in connection with participation in qualifying clinic trials, in accordance with the federal 2021 Consolidated Appropriations Act (CAA).
Summary: Effective January 1, 2022 this amendment proposes to add mandatory coverage of routine patient costs furnished in connection with participation in qualifying clinical trials.