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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: Specifically, it implements a re-base of facility rates based upon SFY 2023 cost report filings, adjusted to reflect rate increases provided after the cost report year ending June 30, 2023.
Summary: Specifically, it implements a one-time supplemental payment of $1,200,000 to each private free-standing chronic disease hospital with Medicaid inpatient utilization exceeding 50% for state fiscal year 2023.
Summary: This amendment is to establish coverage for doula services as a new reimbursable preventative service for individuals navigating pregnancy-related care adding coverage for lactation provider services as a new reimbursable preventative to increase access to education and management to prevent and solve breastfeeding problems and encourage support to breastfeeding mother-infant.
Summary: This amendment is relating to an executive reorganization which will rename the Human Services Department (HSD) as the Health Care Authority (HCA). As a new executive department, HCA will administer laws and exercise functions relating to health care purchasing, policy, and regulation for the State of New Mexico.
Summary: This plan amendment updates procedure codes and fee schedules while also adding reimbursement for donated human breast milk to eligible infants.
Summary: This plan amendment makes updates to rates for long-acting reversible contraceptive (LARC) devices and updates the physician services fee schedule.
