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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: California Disaster Relief (DR) SPA 22-0038 will temporarily implement the addition of Self-Directed Support Services and Technology Services and temporarily implement increases to incentive payments for Prevocational and Supported Employment Services. This SPA is effective July 1, 2021 through the end of the COVID-19 Public Health Emergency (PHE).
Summary: This SPA establishes an Alternative Payment Methodology (APM) for qualifying Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to pay a per visit add payment to providers that are providing additional level of engagement to integrate, coordinate health care, and manage the array of beneficiary health complexities.
Summary: This SPA will reduce premiums to $0 for the Optional Targeted Low-Income Child (OTLIC) group, which covers eligible individuals with a family income determined to be above 160 percent of the Federal Poverty Level.
Summary: This SPA will reduce premiums to $0 for the Working Disabled Program, which covers eligible working disabled individuals with a family income up to 250 percent of the Federal Poverty Level.
Summary: This SPA provides Hawaii with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This SPA proposes to add routine patient costs associated with participation in qualifying clinical trials as a Medi-Cal benefit effective July 1, 2022 to comply with the Consolidated Appropriations Act of 2021, which amended the Social Security Act to add a new section 1905(gg) to cover this item.
