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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: To incorporate additions to the benefits and payment state plan pages in order to implement the Center for Medicare & Medicaid Innovation's (CMMI) Integrated Care for Kids (InCK) ModeL a child-centered local service delivery and state payment model The state will limit implementation of the InCK Model to two counties in the state utilizing CMMI waiver authority in section 1115A(d)(1) of the Social Security Act. The CMMI waiver authority is applicable only while the New Jersey InCK Model is implemented in accordance with the InCK Model's Terms and Conditions of Award.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement coverage of COVID-19 vaccine administration and COVID-19 Test administration when provided by pharmacists, pharmacy interns and pharmacy technicians, to the extent authorized by the PREP Act; and 2) Effective December 11, 2020, establish reimbursement rates for the COVID-19 vaccine administration at 100% of the Medicare rate.
Summary: Suspends the Medicaid Recovery Audit Contractor Program, a requirement in section 1902(a)(42)(B)(i) of the Social Security Act, for a two year-year period because ninety-seven percent of Medicaid beneficiaries participate in managed care.
Summary: This amendment proposes to include an attestation that the state provides non-emergency medical transportation (NEMT) services consistent with the provisions outlined in the Consolidated Appropriations Act, 2021.
Summary: this amendment proposes temporary rate adjustments to State University of New York (SUNY) Upstate Medical University for inpatient psychiatric services through March 31, 2025.
Summary: This amendment continues authorization for $24,000,000 in Graduate Medical Education Supplemental (GME-S) Subsidy payments made on behalf of individuals enrolled in the New Jersey CW Demonstration.