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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 SPA authorizes an Alternative Payment Methodology (APM) for the insertion and removal of Long-Acting Reversible Contraction (LARC) Services and for LARC devices when provided at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
Summary: This SPA is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This amendment is submitted as part of the agency rate standardization project. The Oregon Health Authority will set the rate methodology for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) and Home Enteral/Parenteral Nutrition and IV Services under the Home Health state plan benefit at 80% of 2024 Medicare rate.
Summary: This plan amendment changed the reimbursement methodology for publicly owned Ground Emergency Medical Transportation (GEMT) providers from a cost-based reimbursement methodology to a uniform add-on rate.
Summary: This plan amendment updates inpatient reimbursement methodologies of changing cost-settled rates for critical access hospitals to cost-based rates, unbundling long-acting reversible contraceptives from general acute and critical access hospital per diems, and allowing costsettled rates for swing-bed providers.
Summary: This amendment is to renew Nevada’s 1915 State Plan HCBS benefit; to identify additional individuals qualified to perform 1915 evaluations reevaluations of eligibility, to perform the independent assessment of needs, and to develop the person-centered service plan; and to clarify performance measures within the quality improvement strategy.
