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Medicaid State Plan Amendments
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 time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow cover the new optional group for COVID testing; apply less strict resource and income methods when determining eligibility for certain individuals; consider individuals evacuated from the state due to the emergency to continue to be residents; provide medical coverage to non-residents who are quarantined in the state due to COVID-19; allow hospitals to make presumptive eligibility decisions for certain individuals; suspend enrollment fees and premiums for all individuals; expand telehealth; add certain benefits and increase some payment rates related to the COVID-19 national emergency.
Summary: Proposes a five percent (5%) increase to reimbursement rates for inpatient hospital services including: Diagnosis-related group inpatient hospitals, freestanding rehabilitation hospitals, and inpatient critical access hospitals
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.
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 remove the requirement for Prior Authorizations for service destinations and non-emergency services for ambulances during the COVID-19 emergency.
Summary: This SPA amends the Specialized Services section in the State Plan to note that specialized services delivered at the facility or those that take the resident into the community may be suspended due to a state or federal national emergency.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. In this amendment Alabama elects to suspend Medicaid copayments for all services for all Medicaid beneficiaries during the time of the Public Health emergency and to utilize telehealth for some Medicaid services.