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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to rescind a temporary rate increase for outpatient hospital services as approved under Disaster Relief SPA TN 20-0009.
Summary: Establish coverage and reimbursement for alternative treatments for pain management under the rehabilitative services benefit. This new optional service for adults will help Medicaid beneficiaries with chronic pain reduce reliance on opioid medications to manage their pain.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow a temporary supplemental payment for long-term care facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) to support increased costs due to COVID-19.
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 the administration fee of the COVID-19 vaccine up to the Medicare rate, without geographic adjustment, in effect at the time of service.
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 request coverage and reimbursement for PREP Act qualified professionals, including but not limited to pharmacists, for administration of all ACIP-recommended vaccines and seek coverage and reimbursement of administration of the COVID vaccine and countermeasures for physicians and other PREP Act qualified professionals, including pharmacists.
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 amend its state plan for four changes; three of which involve rate increases and an enhanced rate for NEMT providers during the PHE, and one providing authority to make quarterly payments to MRI/DSH/GAP payments to hospital providers.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. This second Medicaid Disaster Relief SPA for North Carolina includes temporary modifications to benefit and payment provisions during the emergency declaration period. The state is proposing the following temporary rate increases: 1) a 10% rate increase for certain providers facing a disproportionate impact during the pandemic, 2) a 5% general increase to all providers that have not yet received one as required by the State’s General Assembly, and 3) authority to provide payments to pharmacy providers for mail-prescriptions to reduce direct contact for beneficiaries and providers.