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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: Effective February 1, 2021, this amends the current targeted case management state plan amendment for public health nurse home visiting to include three additional counties (Baker, Clatsop and Marion).
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 increase certain payment rates and to allow additional providers the ability to order Home Health services including Durable Medical Equipment.
Summary: This amendment aligns the home health services rule with the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act, and federal regulation, by adding nurse practitioners, clinical nurse specialists, and physician assistants to the list of practitioners who can order home health services.
Summary: This amendment changes the year October 1, 2020 through September 30, 2021 from a rebasing year to a non-rebasing year for Nonstate Operated Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) and Community Residential Facilities for the Developmentally Disabled (CRFs/DD).
Summary: Updates the fee schedule methodology for EPSDT, Home Pharmacy Services, Medical Supplies, and Dental services in response to a Companion Letter issued by CMS with the approval of SPA 19-0005
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 temporary rate increases of 2.3% for home health aide services provided by home health agencies, specifically HCPCS T1004, T1021 effective Sept 1 through October 31, 2020.
Summary: Updates the plan to expand coverage and reimbursement for vaccine administration in accordance with authorizations provided under the Public Readiness and Emergency Preparedness (PREP) Act declaration. Further, it clarifies the reimbursement methodology for medically necessary vaccines products; expands the list of practitioners able to order Home Health services; clarifies the administrative vaccine rate for children eligible under the Vaccine for Children (VFC) Program; and, incorporates reimbursement for administration of vaccinations to the adult population.