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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: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend, without, without modifications, the 5% rate increase to rates for nursing facilities, assisted living facilities, residential care facilities for a temporary period of 5/12/23 through 6/30/23.
Summary: This SPA is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORD Act, Pub. L. No. 115-217, section 1002.
Summary: This SPA is to make a change regarding when benefits are provided. Once the reasonable opportunity period is provided, the agency furnishes benefits on the first day of the month of application.
Summary: This amendment is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.
Summary: This SPA increased the hourly rate for agency providers by 1.6%, an expected weighted average increase of $0.56, decreased the hourly rate of Consumer Directed Employers (CDE) by 0.1%, an expected weighted average decrease of $0.04 and increased the mileage reimbursement to the Internal revenue Service (IRS) rate of $0.655 for 2023.
Summary: This SPA pays participating programs at enhanced rates for approved services. Credentialed providers would receive a 10% increase over the fee-for-service fee schedule. Providers with a credential of master’s level or above would receive a 20% increase. Residential providers would receive a 15% increase.
Summary: This amendment expands school-based health services (SBHS) under the Rehab benefit by 1) adding specialized transportation to school-based rehabilitative services and 2) increases reimbursement for students covered under the Individuals withDisabilities Education Act (IDEA). The SPA also introduces a new reimbursement methodology for SBHS.
Summary: State is amending the Community First Choice (CFC) program to add an option that allows level of care assessments to be completed remotely when an in-person visit is not possible and also adds language that allows participants and providers to finalize the person-centered plan with an electronic signature.
Summary: This Alternative Benefit Plan amendment is to add coverage and reimbursement of community violence prevention services performed by certified violence prevention professionals as a new benefit.
