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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 amendment proposes to increase the number of days of therapeutic leave for Medicaid-eligible beneficiaries occupying beds in Nursing Facilities or Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) from 60 to 90 in any calendar year.
Summary: This amendment allows Medicaid to cover and reimburse six family planning inter-periodic visits in addition to an annual assessment and comprehensive preventive medicine exam per 365 days.
Summary: Applies ECU Health Physicians to the same limit on payments that applies to eligible providers affiliated with the East Carolina University Brody School of Medicine.
Summary: This SPA provides North Carolina with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: increases Medicaid Direct rates for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), including ICF/IID-level group homes, enrolled in the Medicaid / NC Health Choice program. ICF/IID providers receiving this rate increase shall be required to use at least eighty percent (80%) of the funding that results from the rate increase to raise pay rates to direct care employees.
Summary: This state plan amendment allows North Carolina Medicaid to increase rates for Child/Adolescent Day Treatment, Community Support Team, High-Risk Intervention, Partial Hospitalization, Peer Support Services, Psychosocial Rehabilitation, Substance Abuse
Intensive Outpatient Treatment, and Substance Abuse Comprehensive Outpatient Treatment, as proposed in the HCBS Spending Plan.
Summary: increases the percentage used to calculate rates for Certified Registered Nurse Anesthetists (CRNA) Services to 100% of North Carolinas’ Medicaid Physician Fee Schedule.
