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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 establishes coverage of Certified Community Behavioral Health Centers (CCBHCs) and reimbursement of CCBHC services using a prospective payment system.
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 provide temporary rate increases for providers (Adult day health, day habilitation, adult foster care, children's behavioral health initiative, private duty nursing (continuous skilled nursing), durable medical equipment, home health, personal care attendants) in accordance with Massachusetts' approved Initial Spending Plan for home and community based services under the American Rescue Plan Act of 2021.
Summary: Updates the State Plan language regarding the Community First Choice program to replace references to the attendant care and the LTSS tracking System with personal assistance services and data management.
Summary: Amends provisions governing reimbursement for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in order to establish an alternative payment methodology which would allow reimbursement outside of the
current Prospective Payment System rate for community health worker services provided in FQHCs and RHCs.
Summary: Approved the State’s request to amend its State Plan to add a new 1915 Home and Community Based Services (HCBS) benefit. As part of the SPA, Illinois revised its 3.1-F pages, which authorizes Managed Care under 1932(a) to include the new 1915 program.
Summary: To align Ohio’s Alternative Benefit Plan with the Medicaid State Plan by adding language for coverage of inpatient hospital treatment of chemical dependency and intensive home-based treatment, which is a component of the OhioRISE program, under the early and periodic screening, diagnosis, and treatment benefit for individuals under age 21.
Summary: Proposes to establish coverage and payment for intensive home-based treatment (IHBT), which is a component of the OhioRISE program, under the early and periodic screening, diagnosis, and treatment benefit for individuals under age 21.
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 implement a quarterly supplemental payment to certain Home and Community Based Services provider types.