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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: Clarifies which Non-Emergency Medical Transportation (NEMT) procedure codes are eligible to receive a time-limited supplemental payment (through December 31, 2021)
Summary: Proposes to authorize the state to enter outcome-based supplemental rebate agreements with drug manufacturers for drugs provided to the Medicaid program
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to expand telehealth, allow e-signatures to person-centered service plans in place of in-person ink signatures to minimize in person contact and allow verbal consent as authorization for providers to deliver services while awaiting receipt of the signed person-centered service plan, and allow certain home and community based services to be provided to individuals in inpatient settings.
Summary: Proposes to reimburse for psychiatric diagnostic evaluations services for beneficiaries under 21 years of age at 100% of the annual Medicare rates published each year.
Summary: Adjusts the Medi-Cal Fee-for-Service (FFS) reimbursement rates for Durable Medical Equipment (DME) services using the Medicare rural fee schedule for DME, Prosthetics, Orthotics, and Supplies
Summary: Adds Orange County (Group 4) to the existing Health Home Program with the population criterion of Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED)