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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 is to remove the High Fidelity Wrap-a-round (HFW) language from the Health Home SPA since it will now be a part of a new 1115 to prevent duplication of services.
Summary: This amendment will create a Hospital Augmented Reimbursement Program for private hospitals to preserve the financial resources many Texas hospitals depend on to provide access and quality care to Medicaid clients.
Summary: The proposed amendment will allow the Texas Health and Human Services Commission (HHSC) to make Medicaid Direct Graduate Medical Education payments to non-government owned or operated teaching hospitals.
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 end coverage for the COVID-19 testing group at 1902(a)(10)(A)(ii)(XXIII) of the Act as described in New Mexico Disaster SPA 20-0007.
Summary: Establish a temporary rate add-on for nursing facilities for miscellaneous costs through August 31, 2023 to maintain the temporary rate increase for nursing facilities that was originally implemented for the federally declared COVID-19 public health emergency (PHE).
Summary: This SPA proposes to update the state's excluded drug list to include selective non-prescription drugs and other excluded drugs and list them on the state's website.
Summary: This SPA proposes reimbursement for providers of Personal Care Services (PCS) and Private Duty Nursing (PDN) services under the Early Periodic Diagnostic and Treatment (EPSDT) benefit will be set at the same rate as 1915(c) provider rates.
