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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: This amendment makes provisions governing the medical transportation program to establish guidelines for the administration and distribution of Elevated Level of Care (ELOC) services by non-emergency medical transportation (NEMT) vendors that meet the criteria to provide an ELOC service to Medical beneficiaries, and to clarify language regarding non-emergency medical ambulance transportation (NEAT) services.
Summary: This amendment updates HCPCS reimbursement to physician office & outpatient/radiology/surgery, independent radiology, MEDS, lab, adult/children dental services, audiology/speech & language, ambulatory surgical centers, rehab/medical and behavioral health clinics. This SPA also updates reimbursement to physician admin drugs; adult complex skilled nursing services; long-acting reversible contraceptives (LARCs) and adds periodontal SRP services. It also extends rate add-ons for pediatric inpatient psych and the states person centered medical homes (PCMH+) program.
Summary: This amendment is to revise the provisions governing the Preventive Services program in order to expand coverage for tobacco cessation counseling services to all Medicaid beneficiaries.
Summary: This SPA is to amend the provisions governing adult dentures services in order to link reimbursement rates to the Louisiana Medicaid fee schedule.
Summary: This SPA is to amend the provisions governing Early and Periodic Screening Diagnostic and Treatment dental services, in order to link dental services to the Louisiana Medicaid fee schedule.
Summary: This amendment expands the coverage and payment for the use of Silver Diamine Fluoride (SDF) to all HUSKY Health (Medicaid) children and adults who receive dental services.
Summary: his amendment establishes coverage and reimbursement for substance use services provided in outpatient and residential setting within the rehabilitative services category.
