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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 adopts provisions governing incurred medical and remedial care expenses in the determination of financial eligibility for the Medical Assistance Program in order to deduct expenses incurred for necessary medical and remedial care, subject to the reasonable limits, from the individual's income when calculating patient liability to an institution and to limit the time institutions have to report these expenses.
Summary: This amendment is to comply with Section 5112 of the Consolidated Appropriations Act (CAA) 2023, which requires states to provide continuous eligibility to children under the age of 19 in Medicaid.
Summary: This amendment is to include new resource disregards in its state plan for purposes of determining financial eligibility for certain Medicaid eligibility groups.
Summary: This SPA 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 (SUPPORD Act, Pub. L. No. 115-217, section 1002.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, and remove language that requires Pediatric Day Healthcare Center (PDHC) closure in order for families to receive services in a residential setting.
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 cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
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 cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
Summary: Proposes to establish qualifying criteria and a for disproportionate share hospital (DSH) payment methodology for West Jefferson Hospital, a major medical center located in southeastern area of Louisiana