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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: Adds coverage in the preventive services benefit category of the State Plan for medically necessary services to treat autism spectrum disorders (ASD) pursuant to the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services benefit for Medicaid members under age twenty-one. SPA 15-004 also establishes reimbursement for qualified providers to perform services to treat ASD pursuant to EPSDT for Medicaid members under age twenty-one.
Summary: This SPA amends Attachment 4.19-8 of the State Plan in order to increase fees for injectable codes (J codes and certain A, S and Q codes) to I 00% of the applicable April 2013 Medicare fee for physicians, mid-level practitioners (nurse practitioners, physician assistants, certified nurse-midwives, and pediatric and family nurse practitioners) and medical clinics.
Summary: This SPA updates reimbursement rates for inpatient psychiatric services for individuals under the age of 21, removes language restricting eligible providers to non-profits, removes language targeting individuals with a serious emotional disturbance for service eligibility, and corrects a previous error of placement of this reimbursement methodology in Attachment 4.19-8.
Summary: This SPA removes the section of the State Plan titled Telemedicine Applications, as telemedicine is not a1905(a) service but instead a service delivery method and it is not required on the plan page.
Summary: Changes the requirement for prescription refills to provide that a refill is allowed without prior authorization when the patient has consumed at least 93 percent of the original or latest refill prescription.
Summary: Authorizes supplemental payments to qualified small independent acute care hospitals in the amount of $11.8 million for state fiscal year 2017.
Summary: This SPA revises Alaska's Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) to clarify private-duty nursing, hospice, chiropractic, nut odiatry services available to individuals nder 21 years of age.
Summary: This SPA is an amendment to Connecticut' s approved Title XIX Medicaid State plan to renew the home and community-based services benefit under Section 1915 (i ) of the Social Security Act for individuals 65 and older who meet the needs-based and financial eligibility criteria in the approved SPA.
