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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: State is increasing the rates for the following 1915(i) services: peer support, family peer support, and training and supports for unpaid caregivers. Other revisions to the state plan include modifications to the requirements of care coordinators, individual provider qualifications for the housing support service, and the quality remediation process for quality measures in the state plan.
Summary: This SPA pays participating programs at enhanced rates for approved services. Credentialed providers would receive a 10% increase over the fee-for-service fee schedule. Providers with a credential of master’s level or above would receive a 20% increase. Residential providers would receive a 15% increase.
Summary: This amendment expands school-based health services (SBHS) under the Rehab benefit by 1) adding specialized transportation to school-based rehabilitative services and 2) increases reimbursement for students covered under the Individuals withDisabilities Education Act (IDEA). The SPA also introduces a new reimbursement methodology for SBHS.
Summary: Effective for dates of service on or after January 1, 2023, this amendment provides for an inflationary increase of 3.75 percent for nursing facility (NF) services and implements a new payment methodology for prope1iy costs.
Summary: This Alternative Benefit Plan amendment is to add coverage and reimbursement of community violence prevention services performed by certified violence prevention professionals as a new benefit.
Summary: This SPA makes changes to the definition of home with settings in which normal life activities take place to better align the language with CMS regulations from 2017, and was originally approved on December 1, 2021.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend, without modifications, the 5% increase in payment rates for ODDS services and settings approved under DR SPA OR-22-0028 for a temporary period of 5/12/23 through 6/30/23.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend, without modifications, the wage add-on for Home and Community-Based Service (HCBS) providers approved under DR OR-23-0005 for a temporary period of 5/12/23 through 6/30/23.
