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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: extended the temporary rate increase of 150 percent of the hospital's fee-for-service rates that was originally implemented effective July 1, 2018, which is now extended through June 30, 2023, to then be returned to the payment levels and methodology for these hospitals that were in place as of January 1, 2018.
Summary: Adds peer support and coordination services, which are provided to individuals after an opioid overdose, to the state’s Alternative Benefit Plan (ABP). These peer support and coordination services have been added to the benefit package in the Medicaid state
plan and this SPA would align the benefits of both benefit packages.
Summary: proposes updates to Attachments 3.1-A and 3.1-B of the Medicaid State Plan to update the Person-Centered Medical
Home Plus (PCMH+) program’s quality measures, which are used as part of the calculation methodology for the individual pool and challenge pool shared savings payments. These updates are necessary to reflect various changes to the measures by the applicable measure stewards. These changes include removing quality measures that have been retired, incorporating changes to the measures that have been made by the measure stewards, and updating measures to new stewards as appropriate.
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 temporarily include retainer payments to address emergency-related issues.
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 disregard income, resources, and a build-up of assets as assistance from a federal, state, local or tribal government for aged, blind and disabled populations.
Summary: The primary purpose of this SPA is to remove health home program services which will be covered and reimbursed under the state plans Certified Community Behavioral Health (CCBH) services.
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 establish a July 2021 COVID-19 interim payment for primary care medical providers (PCMP) who provide integrated services. PCMPs who received a February 2021 (approved in TN 21-0003) or October 2020 COVID-19 interim payment (approved in TN 20-0035) are not eligible to receive the July 2021 COVID-19 interim payment.