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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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to implement, as authorized under section 9811 of the ARPA, P.L. 117-2, COVID-19 treatment services, without cost-sharing, for enrollees in the COVID-19 uninsured testing group and enrollees in the adult group who are covered by an alternative benefit plan (ABP).
Summary: This plan amendment revises the FQHC methodology to include (a) an update to 2018 as the cost report base year for determining provider specific Prospective Payment System (PPS) rates and (b) adding an Alternative Payment Methodology (APM) in compliance with CMS Companion Letter to North Carolina Disaster Relief State Plan Amendment (SPA) 20-0016.
Summary: This amendment proposes changes to incorporate language based on provisions for Medicaid non-emergency medical transpo1iation (NEMT) services added to Section 1902(a)(87), Title XIX of the Social Security Act, as part of the Consolidated Appropriations Act, 2021.
Summary: This amendment proposes to add four types of clinicians to the providers qualified to provide core services in Federally Qualified Health Centers: licensed certified social workers, licensed professional counselors, licensed mental health counselors, and licensed marriage and family therapists.
Summary: This amendment proposes to update the third-party liability and the Health Insurance Premium Payment program (HIPP) sections of the state plan.
Summary: state adopts the "Katie Beckett" eligibility group, which serves children who have disabilities and are under the age of 19 and who will receive services in the community instead of an institution.