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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 is to add three new providers - Doulas, Community Health Workers (CHWs) and Registered Pharmacists - to Nevada’s Alternative Benefits Plan (ABP) pages.
Summary: Increases rates to services provided by Psychiatric Rehabilitation Services provided by Community Mental Health Centers and Independent Clinics (except for Federally Qualified Health Centers (FQHCs)), Ambulatory Surgical Centers, Medicaid Children’s Clinics, Public Health Clinics, and Planned Parenthood Clinics. Based upon the information provided by the State
Summary: Updates the State Plan language regarding the Community First Choice program to accurately reflect the highest allotted budget for personal Assistance Services based on the Resource Utilization Groups (RUG), which is $43,680 annually.
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 establish a direct wage floor and workforce retention bonus payments to long-term personal care providers, in accordance with the State's approved Home and Community Based Services spending plan authorized under Section 9817 of the American Rescue Plan Act.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to: Income that would have otherwise been part of an individual's liability for his or her institutional or home and community-based waiver services based on application of the post-eligibility treatment-of income (PETI) rules, but which became countable resources on or after March 18, 2020. Such resources will be disregarded through the twelve months following the end of the month in which the COVID-19 public health emergency ends.
Summary: Updates Home rates to reflect a 1% across the board rate increase for Health Homes serving adults and children, and adjusts Health Home Plus rates statewide to reflect a 5.4% cost of living adjustment.
Summary: Provides a 5.4 percent cost of living adjustment for Care Coordination Organization/Health Homes for individuals with intellectual and developmental disabilities.
Summary: Implements a one-time 7.25% rate increase, provided through the Maryland budget bill, for the 1915i Home and Community Based Services Program.
Summary: The SPA revises the maximum fee rates for substance use disorder (SUD) health home rates. Two new billing tiers have been added to the per-member-per-month reimbursement rate that providers receive for administering the six core health home services. The billing requirements to qualify for tiers of reimbursement will no longer be determined by direct time (time spent with the member in-person or via telehealth) but rather by delivery of core service time.
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 a temporary reimbursement increase . The rescission includes the additional $20 per-patient-per-day for nonpublic nursing home facilities as well as the provisions for managing the additional payments within the nursing home rate setting system.