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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 updates state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set as outlined in 42 CFR 431.16 and 437.10 through 437.15.
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 add homemaker services during the COVID-19 public health emergency (PHE) for Idaho’s 1915(i) HCBS Adult Developmental Disability Program. The SPA also authorizes a waiver of signatures for drug dispensing during the PHE.
Summary: modify the Case Management reimbursement and structure for the Primary Care Case Management Program known as Healthy Connections, and align it with the Healthy Connections Value Care Program.
Summary: Effective January 1, 2021, this amendment changes the methodology and thresholds for determining cost-effectiveness for Medicaid Estate Recovery and clarifies the definition of "recoverable medical assistance."
Summary: Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Summary: amends Idaho’s Basic Alternative Benefit Plan (Basic ABP) to add children’s habilitation intervention services to the Basic ABP. The habilitation intervention services for children include Habilitative Skill, Behavioral Intervention, Interdisciplinary Training, and Crisis Intervention services.
Summary: amends Idaho’s Enhanced Alternative Benefit Plan (Enhanced ABP) to add children’s habilitation intervention services to the Enhanced ABP. The habilitation intervention services for children added to the Enhanced ABP also include Habilitative Skill, Behavioral Intervention, Interdisciplinary Training, and Crisis Intervention services.
