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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: Adds licensed professional counselors and licensed marriage and family therapists to the core services proved by Federally Qualified Health Centers and Rural Health Clinics. The amendment also added pharmacists and licensed dietician-nutritionists to the list of other ambulatory services offered by Federally Qualified Health Centers and Rural Health Clinics.
Summary: This amendment continues authorization for Medical Assistance Day One Incentive (MDOI) payments to nonpublic nursing facilities and provides the funding levels for the MDOI payments for Fiscal Year (FY) 2023-2024.
Summary: This plan is to amend Pennsylvania’s State Plan to reflect payment for each loaded mile of ambulance ground transportation and to change the date that the agency’s fee schedule rates were last updated.
Summary: Adds language specifically stating that for beneficiaries under 21 years of age, there are no limits for medically necessary home health nursing services, medically necessary home health aide services, medically necessary home health physical therapy, occupational therapy, speech pathology and audiology services.
Summary: This plan amendment authorizes the Department to make an additional payment to nonpublic and county nursing facilities that qualified for supplemental ventilator care and tracheostomy care payments in a city of the first class.
