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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: Updates the plan to expand coverage and reimbursement for vaccine administration in accordance with authorizations provided under the Public Readiness and Emergency Preparedness (PREP) Act declaration. Further, it clarifies the reimbursement methodology for medically necessary vaccines products; expands the list of practitioners able to order Home Health services; clarifies the administrative vaccine rate for children eligible under the Vaccine for Children (VFC) Program; and, incorporates reimbursement for administration of vaccinations to the adult population.
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 update Payment Methodologies for Certain Hospital, Community Health Centers, Physician, and coverage for mobile testing service done by EMTs during the COVID-19 Emergency period.
Summary: Proposes to allow Physician Assistants to bill independently from the supervising physician. The SPA also establishes a rate payment for Physicians Assistants
Summary: Implements a resource disregard of earnings accumulated in a separate account during an individual's enrollment in a working disability eligibility group when determining the individual's subsequent eligibility for other eligibility groups covered under Washington’s state plan
Summary: Requires the use of an Electronic Visit Verification (EVV) system for personal care services (PCS) that require and in-home visit
by a provider.
Summary: Effective January 24, 2021, this amendment continues Pennsylvania's authority to continue Medical Assistance Day One Incentive (MDOI) payments to nonpublic nursing facilities and sets the funding levels for Fiscal Year 2021.
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 the state to increase the payment for a reserved day for therapeutic leave of absences for a resident of an intermediate care facility to 60 days.
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 pay a one time supplemental payments to chronic disease and rehabilitation inpatient hospitals.