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Medicaid State Plan Amendments
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 respond to the COVID-19 national emergency. The purpose of this amendment is to update payment Methodologies For Certain Long-Term Services and Support during the COVID-19 Emergency Period as well as expand the provider types that can order, certify and recertify member's home health care plans.
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 expand telehealth, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, and adjust prior authorizations for medications.
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 rescind the following parts of Section 7.4 of the existing state plan: 1) Election A.1 to furnish medical assistance to uninsured group under 1902(a)(10)(A)(ii)(XXIII) and 1902(ss) of the Act; and 2) Election of B.1. to allow hospitals to make presumptive eligibility determinations for uninsured individuals described at section 1902(a)(10)(A)(ii)(XXIII) of the Social Security Act.