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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 SPA was approved to add sickle cell disease as a single qualifying condition for Health Homes Serving Adults and Health Homes Serving Children.
Summary: This SPA propose to raise the effective income eligibility standards for certain individuals who are otherwise eligible to receive services through NC TBI waiver.
Summary: To incorporate additions to the benefits and payment state plan pages in order to implement the Center for Medicare & Medicaid Innovation's (CMMI) Integrated Care for Kids (InCK) ModeL a child-centered local service delivery and state payment model The state will limit implementation of the InCK Model to two counties in the state utilizing CMMI waiver authority in section 1115A(d)(1) of the Social Security Act. The CMMI waiver authority is applicable only while the New Jersey InCK Model is implemented in accordance with the InCK Model's Terms and Conditions of Award.
Summary: This SPA amends Attachment 3.1-D of the state plan to comply 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: This SPA proposes that the state may not adjust the patient liability of an individual receiving Medicaid Coverage for certain long-term services and supports during the COVID-19 based on public health emergency.
Summary: This amendment updates the state plan to reflect current policy for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs). Specifically, this amendment clarifies that ICF/IIDs, in addition to nursing facilities, are qualifying providers eligible to receive payments for reserved bed days while the ICF/IID resident is temporarily absent from the facility.