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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: Effective May 1, 20201, this amendment replaces certified diabetes educator requirements with more pertinent training/experience for existing providers of diabetes self-management education and support services(DSMES). Additionally, the amendment adds licensed health care professionals who hold a board certification in advanced diabetes management are certified diabetes care and education specialists, or are under the supervision of a licensed practitioner within state scope of practice as a provider of DSMES services.
Summary: Effective September 1, 2020, this amendment provides targeted rate increases for providers of mental health and behavioral health services, specifically individual psychotherapy, substance use assessment, and day rehabilitation services.
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 modify the termination date of some previously approved provisions, to end at an earlier date.
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 disregard any excess resources for LTC members as of the month the PHE ends.
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 provide authority to address the National Emergency by providing Emergency Use Authority for investigational drugs, devices, and biological agents and their administration, as well as by increasing the payment for COVID-19 vaccine administration to 100% of the Medicare rate and by providing authority for an Alternative Payment Methodology to specific providers for COVID-19 vaccine administration.