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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: Effective March 18, 2020, the agency rescinds the election at A.1. of section 7.4 (approved on May 8, 2020 in SPA Number MT-20-0024) of the state plan to furnish medical assistance to the optional eligibility group.
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 authorize administration of COVID-19 vaccines with a FDA Emergency Use Authorization (EUA) status, without regard to the state's limitation on coverage of experimental procedures or services. This SPA also authorizes COVID drug treatments that may be provided under EUA without regard to rebate status.
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 allow flexibility in the setting where autism treatment services are provided and face-to-face requirement during service provision.
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 rescind coverage of the optional COVID-19 testing for uninsured individuals which was approved by CMS on May 11, 2020 under AL DR SPA 20-0007.
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 reinstate the reimbursement methodology for school-based rehabilitation service Comprehensive School and Community Treatment that was approved through December 31, 2019, for the time period March 1, 2020 through June 30, 2020.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow code D1999 (Unspecified preventive procedure) to be billed and reimbursed at $20.00 to allow for reimbursement of PPE and cleaning supplies PPE that are necessary for dental offices to provide treatment to recipients.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide a 20% increase in per diem rates for all COVID-19 diagnosis patients for hospital inpatient stays due to increases in cost associated with staffing, supplies, social distancing standards and other factors.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, allow 90-day supplies of drugs and early refills, allow exceptions to the State's preferred drug list, allow use of telehealth service delivery methods in lieu of face-to-face when appropriate, and to establish supplemental payments for NF/ICF providers.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to increase reimbursement rates for Nursing Facilities during the COVID-19 state of emergency for all costs associated with staffing, supplies, social distancing standards, cleaning fees, etc. AL noted that this increase equates to approx. $20 per diem rate add-on payment for all NF's.