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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: The purpose of the amendment is to update the rate methodology and payment rates for Personal Care Services (PCS) in support of increasing the base wage for certain personal attendants under Medicaid and other programs administered by HHSC to $10.60 per hour, in accordance with the 2024-25 General appropriations Act, House Bill 1, 88th Texas Legislature, Regular Session, 2023 (Article II, HHSC, Rider 30(a)).
Summary: The purpose of the amendment is to update the rate methodology and payment rates for Intermediate Care Facilities (ICF) in support of increasing the base wage for certain personal attendants under Medicaid and other programs administered by HHSC to $10.60 per hour.
Summary: The proposed amendment updates the rate methodology and payment rates for Primary Home Care (PHC) and Community Attendant Services (CAS) to support base wage increases for certain personal attendants. The proposed amendment also revises the initial cost report database to calculate the direct care cost component to be the most recent PHC Medicaid cost report database.
Summary: This amendment modifies the definition of rural hospitals to reflect the population updates in the 2020 U.S. Census and increase the minimum payment for the labor and delivery add-on for rural hospitals
Summary: The purpose of the amendment is to update the rate methodology and payment rates for Day Activity and Health Services (DAHS) in support of increasing the base wage for certain personal attendants under Medicaid and other programs administered by HHSC to $10.60 per hour and revise the initial cost report database used to calculate the direct care cost component to be the most recent DAHS Medicaid cost report database.
Summary: The purpose of the amendment is to update the rate methodology and payment rates for Community First Choice (CFC) services in support of increasing the base wage for certain personal attendants under Medicaid and other programs administered by HHSC to $10.60 per hour.
Summary: The proposed amendment updates the fee schedule for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Hearing Aids and Audiometric Evaluations.
Summary: This amendment is to remove limitations on fee-for-service (FFS) for non-local mental health authorities and local behavioral health authorities of mental health targeted case management per recent state legislature.
