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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 is to provide children under age 19 with 12 months of continuous eligibility in Medicaid, in accordance with Section 1902(e)(12) of the Social Security Act, as amended by Section 5112 of the Consolidated Appropriations Act, 2023. Children under age 19 will remain continuously eligible for the full 12-month certification period, regardless of changes in circumstances with certain exceptions.
Summary: This amendment is to update the state's minimum personal needs allowance for individuals residing in a nursing facility (NF), assisted living facility, intermediate care facilities for individuals with intellectual disabilities (ICFs/IID), or other similar long-term care facility from $60 to $75 for individuals and from $120 to $150 for couples.
Summary: The proposed amendment documents coverage of COVID-19 tests as a benefit in Texas Medicaid, including at-home tests provided through a pharmacy.
Summary: This amendment is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
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 amend the methodology for retention payments to providers delivering HCBS attendant and nursing services through the provider agency and consumer directed services option in the following state plan services: Community Attendant Services program; Primary Home Care program; day activity and health services; Community first choice (CFC) personal assistance services and CFC habilitation services; 1915(i) Home and Community-Based Services--Adult Mental Health Program; and personal care services.
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 waive the counseling signature requirements for the dispensing of drugs during the COVID-19 Public Health Emergency.
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 pay Federally Qualified Health Centers (FQHCs) a Medical Assistance (MA) Fee Schedule rate, equivalent to the Medicare rate, for administration of COVID-19 vaccines beginning December 11, 2020 through end of the PHE.
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 pay Rural Health Clinics (RHCs) a Medical Assistance (MA) Fee Schedule rate, equivalent to the Medicare rate, for administration of COVID-19 vaccines beginning December 11, 2020 through the end of the PHE.
