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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: Allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L.115-271).
Summary: Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Summary: This amendment provides coverage of Diabetes Self-Management Education (DSME), Diabetes Prevention Programs (OPP) and Medical Nutrition Therapy (MNT), to New Jersey Medicaid beneficiaries who are referred by a licensed, registered or certified healthcare professional.
Summary: This SPA proposes to align the physical therapy and occupational therapy benefits under the Alternative Benefit Plan (ABP) with the standards for those benefits in the
regular Medicaid State Plan that were recently approved by CMS under [TN]WV-19-0002. As part of our review of SPA [TN]WV-19-0003, we conducted a review of all individual Alternative Benefit Plan (ABP) templates in the West Virginia State Plan, consistent with CMS policy.
Summary: Increases nursing facility Medicaid per diem rates by $13.2 million over state fiscal year 2019 rates and includes a performance rate add-on for nursing facilities scoring at or above certain metrics
