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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: Effective October 1, 2020 until September 30, 2025, pursuant to 1905(a)(29) of the Social Security Act and Section 1106(b) of the SUPPORT Act, this amendment adds the medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Summary: Effective July 1, 2021, this amendment establishes an ambulance transportation quality assurance fee program that will provide an add-on to fee-for-service emergency ambulance rates for non-public and non-federal emergency ambulance transportation providers. The add-on rate will be funded solely from assessments to the same providers. This assessment and add-on rate will not apply to any unit of government as defined in 42 CFR Sec 13 433.50, including federally recognized Indian tribes.
Summary: Effective January 1, 2021, this amendment adopts a new resource disregard under the authority of section 1902(r)(2) of the Social Security Act. The agency chooses to provide a reasonable timeframe for reducing excess resources accumulated during the COVID-19 public health emergency (PHE) by certain individuals subject to the post-eligibility treatment of income (PETI) rules for long-term services and supports (LTSS). Under FFCRA, these individuals accumulated extra resources, due to no changes being made to their PETI. Income they would have otherwise paid toward the cost of their care resulted in an increase in their resources that began to exceed program standards. This methodology also will prevent an institutionalized beneficiary from having to spend down any such excess resources during the PHE. This methodology will remain in effect through the twelve months following the end of the COVID-19 PHE.
Summary: Effective April 1, 2021, this amendment updated the fee schedule effective dates for several Medicaid programs and services. This is a regular, budget neutral update.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to provide a disregard of certain resources when determining eligibility for individuals that are receiving long-term services and supports under a special income level.
Summary: Creates a new, cost-based per diem rate for substance use disorder (SUD) residential treatment facilities (RTF) operated by the Indian Health Service (IHS) or Tribes to IHS-eligible American Indian/Alaska Native (AI/AN) Medicaid beneficiaries.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to provide an add-on payment to nursing facilities throughout the duration of the public health emergency.