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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 SPA is to bring the state’s alternative benefit plan (ABP) into alignment with the state plan to allow injections for allergy desensitization without prior approval and add marriage and family therapists as a billable provider under federally qualified health centers (FQHCs) and rural health centers (RHCs), effective January 1, 2018.
This amendment proposes to update the Alternative Benefit Plan population, voluntary benefit package selection process and the process for exempting members from mandatory enrollment.
Summary: This Alternative Benefit Plan amendment is to add coverage and reimbursement of community violence prevention services performed by certified violence prevention professionals as a new benefit.
Summary: The SPA clarifies how the premium assistance program determines if premium assistance is estimated to be cost effective and aligns with policies and current practice.
Summary: This amendment allows MO HealthNet to consider participants eligible for, but not enrolled in, a managed care plan for
the Health Insurance Premium Payment (HIPP) program, and determine whether enrolling such participants in HIPP would be cost effective.
Summary: The amendment is to update the Standard Alternative Benefit Plan (ABP) to include Continuous Skilled Nursing services under the Private Nursing provider type.