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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: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to designate Contracted Community Partner organizations as qualified entities to make presumptive eligibility determinations; consider individuals evacuated from the state due to the emergency to continue to be residents; allow flexibility for mobile testing for COVID-19; and waive medication supply limits when appropriate to reduce exposure risk. In addition, this amendment will allow for changes in reimbursement policies and adjustment of payment rates for certain services and providers.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow additional flexibilities for pharmacists; suspend Medicaid copayments for all items and services for all eligibility groups; allow flexibilities for home health and personal care benefits; make payment changes to personal care services; and provide flexibilities for personal care assessments, evaluations, training and person-centered care planning.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide for an extension of the reasonable opportunity period for non-citizens declaring to be in a satisfactory immigration status and to allow licensed practitioners practicing within their scope of practice such as nurse practitioners and physicians assistants, to order home health services.
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to expand Telehealth, adjustments to 1915(i) adult day health services, adjust day supply limits to allow and reimburse for dispensing of a 90-day supply of maintenance medications, waive physician authorization for LTCSS assessment and request for re-assessment, modify certain payment rates, and to modify the My Health GPS health home program to eliminate acuity tiers, face-to-face requirements, and update care team staffing requirements as well as modify reimbursement methodology.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow licensed practitioners within their scope of practice to order & receive reimbursement for laboratory, radiology and home health services, allow laboratory services to be delivered outside an office, or similar facility other than a hospital outpatient department or clinic, when meeting the state’s provider qualifications.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to waive cost-sharing for testing services, testing-related services and treatments of COVID-19 and suspend the face-to-face requirements for community mental health centers.
Summary: Updates the rates for Licensed Practical Nursing (LPN) private duty nursing services provided by a home health agency and adds more comprehensive language describing the reimbursement methodology for Extended Home Health Services.
Summary: Amends the provisions governing the definition of a public, non-rural community hospital, to include Thibodaux Regional Medical Center, formerly owned by a parish, city or other local government or instrumentality, after January 1, 2019.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to increase base payments to nursing homes