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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.
This amendment is to add authority for the Community Care of North Carolina (CCNC) Primaty Care Case Management Entity (PCCMe) program to provide payments to fee-for-service (FFS) providers on behalf of the State, as described by 42 Code of Federal Regulations (CFR) 438.2.
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 flexibilities related to Skilled Nursing Facilities, Personal Care Services, and Nitrous Oxide.
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 coverage for AMH (MCO) medical home fees are payable to the following providers: Physician, Physician group practice, Advance Practice Midwife, Nurse Practitioner, and Physician Assistant.
Updates property values for undue hardship definition and cost effectiveness methodology. Revisions have also been made to the undue hardship criteria by increasing the amount of assets for a qualified undue hardship applicant or related family member.
This amendment allows new providers time to obtain their accreditation through an approved accreditation organization thereby increasing access to services.
Summary: This state plan amendment will allow Medicaid to move the authority for the per member per month enhanced management fees for primary care providers participating in the Carolina Access program from the Primary Care Case Management section of the state plan to the physician reimbursement section of the Medicaid State Plan.
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 Replace COVID Rates.
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 implement a temporary non-HCBS COVID Rate Increase.
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 implement a temporary non-HCBS COVID Rate Increase.