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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 seeks to add Behavioral Support Aides as a new service in the State of Georgia. This new service will provide in home behavioral support aides to children in the home and community-based setting.
Summary: This State Plan Amendment revises Disproportionate Share Hospital (DSH) methodology by increasing the allocation for hospitals receiving direct payment program (DPP) rate adjustments by the amount of the intergovernmental transfers (IGT) or certified public expenditures (CPE) on behalf of the hospital. The amendment also revises the definition of individuals eligible for inclusion in the DSH calculation for uncompensated care (UCC). This change eliminates the Medicare/Medicaid crossover dual-eligible population as well as the Medicaid secondary payor population from the UCC calculation and limits eligible individuals to (1) those who are eligible for medical assistance under the State Plan or under a waiver of such plan for whom the State plan or waiver is the primary payor for such services or (2) those who have no health insurance or other source of third-party coverage.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to Waive any signature for the dispensing of drugs during the Public Health Emergency through May 1, 2022.
Summary: Effective for services on or July 1,2021, this amendment updates the supplemental payment methodology to hospitals for inpatient and outpatient services. Specifically, these changes will associate supplemental payments with quality of services and participation in the Healthy Connections Value Care (HCVC) program, further linking inpatient and outpatient hospital services to quality and value of patient care.
Summary: Renewing Idaho’s Home and Community Base Services (HCBS)1915, Yes Empowerment Services (YES) State Plan Benefit, targeting children with serious emotional disturbances (SED). This benefit will provide respite services for children and youth who have a substantial functional impairment that is measured by and documented through the use of a standardized instrument conducted or supervised by a qualified independent assessor clinician.
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.
