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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: Allow NPs, CNS’s, and PA’s to order home health services, including durable medical equipment and medical supplies, within their scope of practice.
Summary: This SPA updates the third-party liability section of the state plan to use standard coordination of benefits cost avoidance when processing claims for prenatal services.
Summary: authorizes a time-limited payment to developmental screenings for children up to 30 months of age when rendered in Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Indian Services Memorandum of Agreement 638 (HIS-MOA) clinics using Proposition 56 funds
Summary: Implements California Assembly Bill (AB) 1088 (Chapter 450, 2019) for a new income disregard that would allow an aged, blind, or disabled individual to remain eligible for the Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) program once the state pays the individual’s Medicare Part B premiums. The income disregard would disregard from an individual’s income the amount of such individual’s incurred Medicare Part B premium. The purpose of the legislation is to avoid any adverse impacts on beneficiaries.
Summary: This SPA roll back the policy changes made effective by CA-19-0050 and restores the approved policy set forth in California’s State Plan prior to August 1, 2020. Policy changes made effective as of August 1, 2020 by CA-19-0050 cannot be implemented by California until a later date due to the COVID Public Health Emergency. This SPA package removes the Blind Federal Poverty Level and Aged & Disabled Federal Poverty Level income disregards of income up to 138% FPL added in 19-0050, and replaces them with California’s current approved income disregards for the Individuals Eligible for but not receiving Cash Assistance and the Age and Disability-Related Poverty Level coverage groups.
