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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 Alabama Coordinated Health Network (ACHN) Quality Bonus Payment date from July 2021 to October 2021, effective March 1, 2021. The reason for the change is to allow enough run time for historical claims data.
Summary: Effective July 1, 2020, this amendment allows the disregard of Census-based income for certain Non-Modified Adjusted Gross Income (non-MAGI) eligibility groups.
Summary: Creates a Family Planning Presumptive Eligibility (FPE) Program to enroll participants in a temporary eligibility group to receive family planning services. Participants enroll at Family Planning Qualified Entities (FPEQEs), which are Maryland Family Planning Program Delegate Service Sites enrolled in Medicaid that are in good standing. The goal of FPE is to provide a pathway to longer-term Family Planning Program coverage by allowing participants to have timely access to family planning health care services through an on-site, temporary eligibility determination.
Summary: This SPA incorporates the current version of the Program of All-Inclusive Care for the Elderly (PACE) State Plan Amendment preprint and provide State assurances that PACE rates are set at less than 100% of the amount that would otherwise have been paid for a comparable population.
Summary: The categories of providers allowed to order home health services benefit were initially authorized through Disaster Relief SPA DR SPA 20-0003 effective March 1, 2020.
Summary: Increases the Current Asset Value for Nursing Facilities to account for the increased costs of Nursing Facilities and to provide parameters for the Quality Incentive Add-on Payment to Nursing Facilities.
Summary: The amendment change the benefit for EPSDT recipients to two eye exams and two pairs of eyeglasses every calendar year and to change the eye exam and glasses benefit for recipients 21 years of age and older to one per two calendar years.
Summary: Effective October 1, 2020, this amendment creates a public Emergency Service Transporter Supplemental Payment Program (ESPP) for public emergency service transportation providers.
