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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 is to add Licensed Professional Clinical Counselors (LPCCs) to the list of billable practitioners providing services at Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and Tribal FQHCs.
Summary: This amendment is to expand the prescribing authority for enteral formulae from physicians to include physicians, nurse practitioners, clinical nurse specialists, or physician assistants.
Summary: This SPA is to memorialize the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under Alaska's state plan, and make related changes to other eligibility groups covered under its state plan.
Summary: This SPA authorizes reimbursement rate increases for 1915i Independent Living services, Habilitation/Community Living Arrangement services, Participant-directed Day services and Supported Employment services, and Day Services paid rates pursuant to a cost study, effective for dates of service on or after January 1, 2024.
Summary: This SPA authorizes reimbursement rate increases for primary care, obstetric, and non-specialty mental health services effective for dates of service on or after January 1, 2024.
Summary: Effective January 1, 2023, this amendment provides for supplemental payments for private hospital outpatient services for the service period of January 1, 2023 to December 31, 2024. The supplemental payments are in addition to base rate payments and other supplemental payments, paid to private hospitals in California for the furnishing of Medicaid fee-for-service outpatient hospital services.
Summary: The supplemental payments are in addition to base rate payments and other supplemental payments, paid to private hospitals in California for the furnishing of Medicaid fee-for-service inpatient hospital services.
Summary: This amendment aligns the Alternative Benefit Plan (ABP) with the Medicaid state plan by adding specified pharmacist services as a Medi-Cal benefit.
Summary: This amendment aligns the Alternative Benefit Plan (ABP) with the Medicaid state plan by adding coverage for audiology/speech therapy, podiatry, optometric and optician services, and incontinence creams and washes. This SPA also removes the two-visit limit for podiatrist services.
Summary: This amendment expands the qualified providers for behavioral health providers under the rehabilitative and targeted case management benefits.
