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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: To update Delaware State Plan to allow Medicaid recipients institutionalized in long term care facilities to retain an allowance of income to pay for guardianship costs.
Summary: CMS is approving DE-19-0009 which amends the State Plan to allow Medicaid beneficiaries to request coverage from pharmacies of select FDA approved over-the-counter medications through an agreement with the Department of Public Health Medical Director for the purpose of generating a prescription and clarifies the coverage policy related to drugs indicated for the treatment of obesity.
Summary: This amendment provides for reimbursement under single case agreements for inpatient hospital services, outpatient services and nursing facility services where there is a lack of existing New Hampshire enrolled providers able to provide the medically necessary specialized services.
Summary: To allow enrollees to also be enrolled in Managed Care for their acute medical care needs, where in previous years they had been carved out into Fee for Service Medicaid.
Summary: To amend chiropractors' services, specifically, to allow coverage guidelines for treatment more consistent with the licensure scope of practice for chiropractors.
Summary: NH entered into a contract with a new broker for non-emergency medical transportation. This amendment is being submitted to specify in the State Plan that effective May 1, 2022, the state changed the reimbursement methodology from a per member per month risk capitated rate.
