An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: Expands the categories of providers allowed to order home health services to include nurse practitioners, and additionally revises the SPA language to reflect compliance with updated HH regulations and EVV requirements.
Summary: Allows advanced practice registered nurses and physician assistants to order home health services and conduct face to face visits in accordance with 42CFR440.70(f).
Summary: Eliminates the Health Home per member per month (pmpm) “outreach” payment for all members (adults and children) in the case finding group from $75 pmpm to a rate of $0 pmpm.
Summary: Adds Orange County (Group 4) to the existing Health Home Program with the population criterion of Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED)
Summary: update the home health services fee schedule by increasing the rates by one percent (1 %) for Health Care Procedural Coding System (HCPCS) codes Tl00 4 (Services of a qualified nursing aide, up to 15 minutes) and Tl021 (Home Health aide or certified nurse assistant, per visit) provided by licensed home health agencies.
