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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 proposes to revise the North Carolina Point of Sale reimbursement policies and titles, and to allow North Carolina licensed and certified clinical pharmacist practitioners to administer services within the scope of their practice.
Summary: This amendment provides assurances to comply with federal non-emergency medical transportation requirements, as directed by CMCS in July 12, 2021, CMCS Information Bulletin.
Summary: This amendment ensures compliance with Section 209 of the Consolidated Appropriations Act of 2021. CMS supports this change because it brings the state into compliance.
Summary: Allows Dual Special Needs Plans to contract to furnish previously approved ADHP services under the provisions of §1915(a)(l ), which serves all geographic areas in the District, through capitated monthly payments made to the health plan.
Summary: Permits the District of Columbia to comply with the third-party liability requirements authorized under the Bipartisan Budget Act (BBA) of 2018 (Pub. L. 115- 123) and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019 (Pub. L. 116-16), affecting the BBA of 2013.
Summary: Allows health plans to require cost sharing for certain beneficiaries under managed care. This carries over a policy for the same group under the state's fee-for-service programs, and as such will not increase costs or utilization.
