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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: Proposes to reimburse licensed mental health counselors and licensed marriage and family therapists to bill Medicaid directly for services provided within their scope of practice.
Summary: sets an end date of March 31, 2022, for a previously approved one and one-half percent (1.5%) across-the-board payment reduction on hospital inpatient services.
Summary: updates the inpatient hospital reimbursement methodology for inpatient psychiatric services for individuals
under 21 admitted to Residential Rehabilitation Services for Youth (RRSY) programs certified by the New York Office of Alcoholism and Substance Abuse Services (OASAS), by adding a 5.4% statutory cost of living adjustment.
Summary: Updates Home rates to reflect a 1% across the board rate increase for Health Homes serving adults and children, and adjusts Health Home Plus rates statewide to reflect a 5.4% cost of living adjustment.
Summary: Provides a 5.4 percent cost of living adjustment for Care Coordination Organization/Health Homes for individuals with intellectual and developmental disabilities.
Summary: Formalizes Alternative Benefit Plans (ABP) coverage of routine patient costs for items and services furnished in connection with participation by beneficiaries in qualifying clinical trials.
Summary: Proposes to revise the State Plan to include routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials, including those beneficiaries enrolled in Alternative Benefit Plans, pursuant to the Center for Medicaid and CHIP Services requirements.
