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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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to implement, as authorized under section 9811 of the ARPA, P.L. 117-2, COVID-19 treatment services, without cost-sharing, for enrollees in the COVID-19 uninsured testing group and enrollees in the adult group who are covered by an alternative benefit plan (ABP).
Summary: This amendment includes Long-Term Care Facility Reimbursement for services outlined within the State Plan. The amendment updates provisions as authorized in the State's General Appropriation Act for Fiscal Year 2021-22 and makes technical and editorial changes.
Summary: Establishes a new level of reimbursement for Medicaid-eligible individuals who have severe behavioral needs residing in or seeking admission to Intermediate Care Facilities for Individuals with Developmental Disabilities (ICFs/IID), updates buy-back provisions for ICFs as authorized in the State’s Fiscal Year 2021-22 General Appropriations Act, and makes technical / editorial changes.
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 add an Intensive Outpatient rehabilitation benefit for youth with serious emotional disturbance (SED).
Summary: This plan amendment was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for medication assisted treatment services the same as those in effect April 1, 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021.
Summary: Allows the Alabama Medicaid Agency to apply the reimbursement basis for inpatient and outpatient hospital services for State fiscal year 2022 (Medicare and cost, respectively) used in fiscal year 2021 including an adjustment to utilization trends impacted by COVID-19.
