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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: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend the waiver of premiums for the Buy-In program for Working Adults with Disabilities and the Buy-In program for Children with Disabilities.
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 a Nursing Facility Hospital Discharge Supplemental Payment to the COVID-19 disaster relief SPA.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend the waiver of premiums for the Buy-In program for Working Adults with Disabilities and the Buy-In program for Children with Disabilities.
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 revise the percentage of net invoice cost paid for Outpatient Hospital Physician Administered Drugs.
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 allow the state Medicaid agency to reimburse FQHCs at the fee schedule amount for administration of Covid-19 vaccines.
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 a Nursing Facility payment 4/1/22-6/30/22 and correct ASC procedure code 36561 payment amount from $1,813.06 to $1,831.06, effective 8/26/2021.
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 increase COVID-19 vaccine booster reimbursement.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to cover COVID-19 drug treatment provided through Emergency Use Authorization effective March 1, 2020, increase the rate for procedure code 36561 from Ambulatory Surgical Center (ASC) grouper3 to ASC grouper 10, effective August 26, 2021, and increase the reimbursement rate for administration of a COVID-19 vaccine effective September 1, 2021.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to extend the increased payments for nursing facilities and ICF/IIDs under Attachment 4.19-D to June 30, 2021.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to establish a July 2021 COVID-19 interim payment for primary care medical providers (PCMP) who provide integrated services. PCMPs who received a February 2021 (approved in TN 21-0003) or October 2020 COVID-19 interim payment (approved in TN 20-0035) are not eligible to receive the July 2021 COVID-19 interim payment.
