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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 time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow for hospital presumptive eligibility for a number of optional groups and authorizes 2 PE periods within a calendar year while waiting performance standards during the emergency. This SPA also waives all copays during the emergency. These changes also apply to the approved Alternative Benefit Plan. The SPA allows for broad use of telehealth with reimbursement based on the current face-to-face fee schedule. Prior authorization for medications and Preferred Drug List exceptions are modified under this SPA.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend cost sharing for testing services, testing-related services, and treatment for COVID-19 (including vaccines, specialized equipment and therapies); Suspends premiums for Working Disabled and TMA; Allow Home health to be ordered and plans of care authorized by new provider types (Nurse Practitioner, Physician Assistant, Clinical Nurse Specialist; and Nurse Midwife); Increase the NF bedhold to 90 days provided the bed has not been filled; Add teledentistry reevaluation - post operative visit; and add codes and rates for teledentistry services added.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend all cost sharing for all eligibility groups effective May 1, 2020, through the remainder of the public health emergency.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow additional flexibilities for pharmacists; suspend Medicaid copayments for all items and services for all eligibility groups; allow flexibilities for home health and personal care benefits; make payment changes to personal care services; and provide flexibilities for personal care assessments, evaluations, training and person-centered care planning.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the suspend all cost sharing for the Work Incentives group under 1902(a)(10)(A)(XIII) of the Social Security Act and extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, and allow automatic renewal of prior authorization for medications without clinical review or time/quantity extensions.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover testing in non-office locations; provide lab coverage for self-testing; and increase bed hold/therapeutic absence days for nursing facilities and intermediate care facilities for individuals with intellectual disabilities to 60 days per calendar quarter.
Summary: This time limited state plan amendment responds COVID-19 emergency. The purpose of this amendment requests changes to cost sharing requirements for testing, quantity limits for DME and medical supplies, transportation requirements and covered laboratory services for beneficiaries covered under traditional Medicaid and the Alternative Benefit Plans. This also amends Telehealth policy and modification of face-to-face requirements, Pharmacy adjustments to quantity limits and prior authorization requirements for automatic renewal. Provider payment rates are increased under this amendment and modifies to person-centered planning requirements, Long-term care facility cost reporting and practitioner licensing requirements.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to create a Cost Sharing Exemption for COVID-19 Testing Services and Treatments, and provide assurance that NH does not impose any cost sharing related to testing, services and treatments (including vaccines, specialized equipment, and therapies) related to COVID-19.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow individuals who are evacuated or absent from the state due to the public health emergency and who intend to return to the state to continue to be residents of the state, extend eligibility redetermination timeframes for certain beneficiaries to 12 months, waive certain cost-sharing for COVID-19 related services, adjust certain state plan benefits, extend timelines for submission to CMS of cost reconciliation and settlement for school-based providers, and allow for the payment of additional therapeutic leave days for nursing facilities.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend co-payment obligations for outpatient hospital visits and for medications to treat the symptoms of COVID-19, remove 9-hour per week minimum for substance use disorder services and intensive outpatient treatment services (including alternative benefit plans), expand prior authorization for medications by automatic renewal, and make exceptions for brand name drugs.
