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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: Updates service descriptions and adds new rehabilitative services for Medicaid-eligible recipients with mental illness, substance use disorder, or co-occurring mental illness and substance-use disorder diagnoses.
Summary: Through this SPA, Alabama implements mental health parity requirements in section 2103(c)(6) of the Social Security Act (the Act) and regulations at 42 CFR 457.496 to ensure that financial requirements and treatment limitations applied to mental health (MH) and substance use disorder (SUD) benefits are no more restrictive than those applied to medical/surgical (M/S) benefits.
Summary: This is submitted to revise the approved Title XIX State plan to describe changes to the reimbursement methodology for continuous skilled nursing services provided by home health agencies.
Summary: This SPA modifies the DME reimbursement in accordance with the 21st Century Cures Act. Specifically, the pricing methodology for DME items described in section 1861(n) of the Social Security Act will be equal to the lower of the DMEPOS non-rural Medicare rate or the competitive bidding area rate specific to Alabama.
Summary: This SPA adds TCM services for Medicaid-eligible individuals who have a diagnosed substance use disorder or substance-induced disorder, and revises outdated language for Target Group 1, Mentally Ill Adults, and Target Group 3, Disabled Children.
Summary: Continues to pay hospitals for services provided to Medicaid recipients for inpatient and outpatient services utilizing the reimbursement methods in effect on September 30, 2017.
Summary: This State plan amendment updates the Qualified Medicaid Practitioner Enhanced Payment and Average Commercial Rate Demonstration for a calendar year to set a Medicaid teaching physician rate based on a percentage of the Medicare rate.
