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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 amendment is to expand the settings an ambulance provider may transport a beneficiary to from only a nursing facility or hospital to any appropriate setting.
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: Amends Delaware Title XIX State plan specifically to attest that the Delaware Medicaid Transportation program is in compliance with section 1902(a)(87) of the Social Security Act.
Summary: To update Delaware State Plan to bring the state in compliance with the Third-Party Liability Requirements under the Bipartisan Budget Act (BBA) of 2018 and Medicaid Services Investment and Accountability Act (MSIAA) of 2019 practices.
Summary: Provides authority for updates to non-emergency medical transportation (NEMT) provider qualification requirements per the Consolidated Appropriations Act of 2021.
Summary: Proposes to rescind the temporary third-party liability bypass for behavioral health providers who bill a third party but do not receive a response after 30 days.
Summary: This State Plan Amendment ensures that the Health Insurance Premium Payment (HIPP) Program in Missouri operates in the most efficient and cost-effective manner possible by eliminating areas where Medicaid may be paying for multiple premiums on behalf of the same participant.