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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: add a new 1915(i) home and community-based services (HCBS) benefit to Managed Care and to add Community Behavioral Health Support Services - Supported Supervision and Oversight.
Summary: The purpose of this SPA is to incorporate updates that were made in previously approved SPA WA-23-0010 to the service names and practitioners related to rehabilitative services that are delivered using a managed care delivery system. In addition, SPA WA-23-0051 corrects page number references and adds practitioner types to align with practitioners that have been added to the Other Licensed Practitioners section of the State Plan since the Managed Care section was last updated.
Summary: Amends State Plan Attachment 3.1-F, part 2 to reflect the final implementation of the integration of mental health and substance use disorder services (collectively known as "behavioral health") into an Integrated Managed Care (IMC) program and also makes technical corrections
Summary: Requests to amend the provisions governing the public process for managed care organizations (MCOs) by removing language that refers to the utilization of rulemaking to satisfy public comment requirements. The amendment also adds language to require a 30-day public comment period for MCO contract amendments and a 45-day public comment period for policy or procedure changes (unless the Louisiana Department of Health finds that imminent peril to the public's health, safety, or welfare requires immediate approval).
Summary: Amend the provisions governing the enrollment choice period for Medicaid beneficiaries enrolled in a Managed Care Organizations, from a 90-day period to a minimum of 30 days.
Summary: The SPA proposes to comply with the federal requirements of the Affordable Care Act with regards to hospice. The amendment also revises the provisions governing prior authorization for hospice services in order to control escalating costs associated with the hospice program.
