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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: Expands the community based provider agency options for Medicaid recipients who have been found through the PASRR process to need specialized add-on services. Additionally, amendments were made to behavioral support and day habilitation services descriptions to be consistent with state administrative rule language and updates language about settling locations.
Summary: Adds peer support and coordination services, which are provided to individuals after an opioid overdose, to the state’s Alternative Benefit Plan (ABP). These peer support and coordination services have been added to the benefit package in the Medicaid state
plan and this SPA would align the benefits of both benefit packages.
Summary: This amendment proposes to add medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. This letter is to inform you that New Jersey’s Medicaid SPA Transmittal Number #21-0003 was approved on September 23, 2021 with an effective date of October 1, 2020, until September 30, 2025, pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to suspend the collection of data for performance measures other than those identified for the Health and Welfare assurance for the Section 1915 program and notes that the data will be unavailable for this time frame in ensuing reports due to the circumstances of the pandemic.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow for the administration of the COVID-19 vaccine to be reimbursed at a set fee equal to the same amount approved for the vaccine administration in a physician’s office and outside of the daily case mix rate of Nursing Facilities.
