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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 is to modify payments to providers in line with the state’s American Rescue Plan Home and Community Based Services (HCBS) Spending Plan.
Summary: This amendment proposes to add services to the Newborn Nurse Home visiting program, including maternal and newborn physical assessment; anticipatory and supportive guidance.
Summary: Allows supplemental payments to nursing facilities, home and community-based residential facilities and in-home agencies that participate to support provision of health care premiums for eligible employees as required by SB 800 passed during the 2021 Legislative session.
Summary: Will allow a physician assistant (PA), certified nurse practitioner (CNP), and clinical nurse specialist (CNS), to the extent allowed by Texas state licensure, to certify eligibility for home health services, as well as establish and periodically review the home health plan of care.
This State Plan Amendment includes the following revisions to Certified Community Behavioral Health services:
Removes face-lo-face requirement in order to constitute a visit;
Adds telemedicine and mobile unit as a place of service;
Clarifies definition of crisis intervention;
Updates practitioners who can provide services and also name of practitioner with;
Adds Resident Physician as a qualifying practitioner; and,
Updates rate methodology pages for effective date rate methodology for initial payment rates and for rate reconsiderations, and quality incentive payment.
Summary: Changes the reimbursement methodology for two different services available to families involved with the Division of Children, Youth and Families (DCYF): Home Based Therapeutic Services (HBTS) and Child Health Support Services (CHSS).
Summary: Adds that home health services must be ordered by a physician, physician assistant (PA), or advanced registered nurse practitioner (ARNP) as part of a written plan of care.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to authorize licensed nurses employed by home health agencies to administer COVID-19 vaccinations for individuals who: Have difficulty leaving the home to get the vaccine, or Are hard-to-reach due to specific reasons, and face challenges getting vaccinated.