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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: Clarifies language for existing benefits, specifically as they relate to those under the age of 21. The amendment will align the Alternative Benefits Plan (ABP) with the changes to traditional Medicaid.
Summary: This amendment updates the recipient and provider qualifications for Target Case Management (TCM) for individuals with a behavioral health condition.
Summary: This amendment is to update the plan to broaden coverage of nursing services in schools by removing the requirement that nursing services be listed in an to Individualized Education Program (IEP), as well as amend the tobacco cessation counseling services to include that these services must be provided by a licensed practitioner.
Summary: This amendment seeks to modify the reimbursement rates for community behavioral health services, add community health workers to the list of acceptable practitioners, and update the accreditation language.
Summary: This amendment proposes to allow licensed professional counselors, licensed marriage and family therapists, and certified peer specialists to deliver services and be reimbursed by Federally Qualified Health Centers according to the Practitioner's Practice Act.
Summary: This amendment proposes to expand the scope of covered dental services that are available to individuals over age 21. Individuals over age 21 will receive the following medically necessary dental services: diagnostic, preventive, restorative, periodontal, prosthodontic, orthodontic, endodontic, emergency dental services, and oral surgery (inpatient and outpatient).
Summary: This amendment proposes to expand Express Lane Eligibility to include Childcare and Parental Services (CAPS), Refugee Cash Assistance, and the Supplemental Nutrition Program for Women, Infants, and Children (WIC) and is being submitted pursuant to Georgia's amended State Fiscal Year 2023 Appropriations Act.
Summary: The purpose of this amendment is to comply with Section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023) amended Titles XIX to require that states provide 12 months of continuous eligibility (CE) for children under the age of 19 in Medicaid.
