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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 allow Article 29-I Health Facilities to be reimbursed for care and services provided by exempt practitioners as defined under State law who were employed by an authorized setting as of June 24, 2022 and continue to work there or in another authorized setting, working under the supervision of a professional licensed pursuant to Article 153 (psychologists), 154 (social workers) or 163 (mental health practitioners) of the State Education law.
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 the signature requirements for the dispensing of drugs during the Covid-19 Public Health Emergency.
Summary: This amendment will provide enhancement payments to eligible ground emergency medical transport (GEMT) providers by implementing an add-on reimbursement fee to the base rates for eligible emergency medical transportation services.
Summary: This State Plan Amendment extends disproportionate share hospital (DSH) payments to county hospitals and hospitals operated by the State of New York or the State University of New York (SUNY) for the periods April 1, 2022, through March 31, 2025.
Summary: to decrease the administrative burden on enrolled fee-for-service Medicaid members and providers but will continue to meet the federal regulatory requirements at 42 CFR Part 456, Subparts A and B. This will be accomplished through continued utilization monitoring in a postpayment review process, with referral to the Office of Health Insurance Program (OHIP) prepayment Provider on Review Program, and to the Office of the Medicaid Inspector General (OMIG) where suspected fraud, waste or abuse are identified in the unnecessary or
inappropriate use of care, services or supplies by members or providers.
Summary: This amendment proposes to assist nursing facilities by providing a temporary rate adjustment for facilities that are under closure, merger, consolidation, acquisition, or restructuring.
Summary: This SPA provides Alabama with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
