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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 respond to the COVID-19 national emergency. The purpose of this amendment is end Nursing Facility COVID Relief Rate (NF CRR) Payments to Medicaid enrolled nursing facilities.
Summary: Tennessee is submitting this SPA to transfer responsibilities for surveying healthcare facilities in Tennessee from the Department of Health to the Health Facilities Commission (HFC).
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 definition of home-based habilitation to include health and safety supports and services required to maintain a member’s involvement in online education or e-learning, specifically for members ages 17-21 residing outside of the family home. In addition, the SPA seeks approval for retainer payments made in April 2020 to providers of 1915(i) state plan home and community based (HCBS) habilitation services including day habilitation, prevocational services, and supported employment.
Summary: This amendment establishes compliance with mandatory Medicaid coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials.
Summary: Adds a new assessment tool, the LOCUS?CALOCUS. This tool will be used to evaluate whether individuals meet the 1915(i) needs-based on eligibility criteria and to determine the level of need for 1915(i) services. Also amends the needs-based criteria, added provider qualifications and services standards, and amended he performance measures to align with the HCBS 1915(c) Waiver performance measures.
Summary: This amendment assures that Iowa will cover the mandatory benefit for costs of routine services related to participation in clinical trials in the state plan.
Summary: This SPA proposes that the state may not adjust the patient liability of an individual receiving Medicaid Coverage for certain long-term services and supports during the COVID-19 based on public health emergency.
