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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 adds Federally Qualified Health Centers and Rural Health Clinics as providers of home telemonitoring services; clarifies that the term “home telemonitoring services” is synonymous with “remote patient monitoring;” and requires home telemonitoring providers to establish a plan of care with outcome measures for each patient and to share the plan and outcome measures with the patient’s physician.
Summary: The proposed amendment updates the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program fee schedule, effective October 1, 2024.
Summary: This amendment provides 12 months of continuous eligibility (CE) for children under 19 to comply with Section 5112 of the Consolidated Appropriations Act, 2023.
Summary: This amendment is to assure HHSC compliance with the mandatory reporting of the CMS Child Core Set and the behavioral health measures of the Adult Core Set as per Sections 1139A(a)(4)(B) and 1139B(b)(3)(B) of the Social Security Act respectively, beginning in 2024, and annually reporting in subsequent years, on all measures on the Child Core Set and the behavioral health measures in the Adult Core Set.
Summary: The proposed amendment updates the fee schedule for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) and Vision Care Services. Fiscal impact is for reimbursements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Vision Care Services effective date of September 1, 2024.
Summary: The proposed amendment updates the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program fee schedule, effective September 1, 2024.
