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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 family planning services to be reimbursed ninety percent (90%) of the Medicare fee schedule in effect January 1, 2022 and as may be adjusted each July thereafter.
Summary: Allows the Division of Medicaid (DOM) to reimburse for therapy services at ninety percent (90%) of the Medicare rate in effect on January 1, 2022. and as may be adjusted each July thereafter.
Summary: State Plan Amendment (SPA) 22-0010 allows reimbursement rates for orthotics and prosthetics to be updated annually based on eighty percent (80%) of the Medicare rate.
Summary: This SPA provides Georgia with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This amendment proposes to update the legal name of GA Medicaid’s medical management and utilization review vendor, remove the list of specific items and services deemed experimental or investigational, and correctly reflect the non-covered services and procedures.
Summary: GA Medicaid proposes to add a new provider that may render services under the State Plan; Lactation consultants. The Department currently provides lactation services and is seeking to enroll lactation consultations as an individual practitioner.
