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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 will add one (1) encounter eligible visit per IHS-eligible Medicaid beneficiary per day to the currently allowed five (5) encounters per day.
Move authority for the Tribal Health Improvement Program (T-HIP) from a 1915(b) waiver to a 1932(a) SPA, while further aligning the program design with primary care case management entity requirements found in 42 CFR § 438.2.
This amendment is to include the new adult group in Eastern Band of Cherokee Indians (EBCI) Tribal Option primary care case management entity (PCCMe) program eligibility.
Summary: This amendment proposes to allow the remote delivery of Crisis Services for Individuals with Intellectual and/or Developmental Disabilities (CSIDD) through telephonic or other technology in accordance with State, Federal, and Health Insurance Portability and Accountability Act (HIPAA) requirements. Other technology means any two way, real-time communication technology that meets HIPAA requirements.
Summary: This State Plan Amendment outlines the processes that the State will implement to assure that the Urban Indian Organization(s) has (have) opportunities to review any future changes to the Medicaid State Plan prior to implementation.
Summary: This amendment expands the number of acceptable ICD_10 Diagnoses for individual with the diagnosis of brain injury, behavioral health condition and/or substance abuse disorder.
