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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: Complies with Section 1006(b) of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act and State Health Official (SHO) Letter #20-005, by continuing access to medication-assisted treatment (MAT) for opioid use disorders (OUD) through Medicaid coverage of certain drugs and biological products and related counseling services and behavioral therapy.
Summary: This amendment will continue certain benefits changes beyond the end of the COVID-19 Public Health Emergency (PHE). The home health, prescription drug, targeted case management, and nursing facility benefits in this SPA was originally approved on May 24, 2021. At the time of approval, the end date of the PHE was not known. Now that the date is known, this SPA has been updated to reflect an effective date of May 12, 2023.
Summary: Effective January 1, 2021, this amendment incorporates various 2021 Healthcare Common Procedure Coding System (HCPCS) updates, updated the reimbursement methodology to 100% of the January 2021 Medicare Average Sales Price (ASP) Drug Pricing file for physician-administered drugs, immune globulins, vaccines and toxoids and made technical updates to the Person-Centered Medical Home (PCMH) program.
Summary: Effective January 1, 2021 this amendment updates the Migrated_HH.IA-16-013 IA SPMI Health Homes - Managed Care Implementation billing code for the Health promotion services, change family peer support requirements to align with the requirements for peer support, and updates rates.
Summary: The categories of providers allowed to order home health services benefit were initially authorized through Disaster Relief SPA DR SPA 20-0003 effective March 1, 2020.
Summary: Effective January 1, 2021, this amendment updates the maximum amount allowed for the maintenance of a home for beneficiaries living in an institution to follow the Social Security Cost of living adjustment.
Summary: Effective March 1, 2021, this amendment clarifies access to Long-Term Care Community Nursing (LTCCN) services in all appropriate settings; removes the prohibition of using Physical Therapists and Occupational Therapists; increases the approval limit for Electronic Devices from $500 to $1,200; and, updates the Group Care Homes for Children (GCH) rate methodology.