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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: On August 1, 2023, the Centers for Medicare and Medicaid services (CMS) received Missouri State Plan Amendment(SPA) MO-23-0014 to increase the Care Coordination component of the Primary Care Health Home Per-Member-Per-Month rate.
Summary: This amendment allows Licensed Psychologists, Licensed Behavior Analysts, and Licensed Assistant Behavioral Analysts that work in states that border Missouri to provide Applied Behavioral Analysis services to Missouri Medicaid participants.
Summary: This state plan amendment adds language to reimburse ambulatory surgical centers (ASC) from a fee schedule based on Medicare’s ASC Payment System.
Summary: This state plan amendment updates the Medicare fee schedules, MO Healthnet fee schedules and the National Advisory Service (NDAS) used to determine outpatient reimbursement rates.
Summary: This amendment allows occupational therapy assistants, physical therapy assistants, and speech language pathology assistants to enroll as MO HealthNet providers and bill for covered services provided to eligible MO HealthNet participants.
Summary: The purpose of this SPA to implement mandatory coverage and reimbursement of COVID-19 testing, vaccine and vaccine administration, and treatment in accordance with Section 9811 of the American Rescue Plan (ARP) Act.
Summary: Missouri adopts the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. This amendment temporarily extends the waiver of the requirement for Registered Behavior Technicians to have a credential if they have completed all training but are unable to test due to COVID-19 related test center closure or COVID-19 related delays, which was originally approved in Disaster Relief SPA 20-0021.
