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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: Effective for services on or July 1,2021, this amendment updates the supplemental payment methodology to hospitals for inpatient and outpatient services. Specifically, these changes will associate supplemental payments with quality of services and participation in the Healthy Connections Value Care (HCVC) program, further linking inpatient and outpatient hospital services to quality and value of patient care.
Summary: This SPA provides North Dakota with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This Alternative Benefit Plan (ABP) is to amend the State Plan to account for the change in managed care organization for Medicaid Expansion members between ages 21 - 64.
Summary: Renewing Idaho’s Home and Community Base Services (HCBS)1915, Yes Empowerment Services (YES) State Plan Benefit, targeting children with serious emotional disturbances (SED). This benefit will provide respite services for children and youth who have a substantial functional impairment that is measured by and documented through the use of a standardized instrument conducted or supervised by a qualified independent assessor clinician.
Summary: Provides for an inflationary rate increase of .25 percent for intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs).
Summary: With this amendment, the state will 1.) update conflict of interest (COI) standards to define provider shortage areas; 2.) clarify COI safeguards; 3.) update provider qualifications for Care Coordinators by clarifying providers must be at least 18 years old; 4.) update the quality improvement strategy; and 5.) update the non-medical transportation unit of service.
Summary: This amendment to amend the State Plan to include additional provider types for rehabilitative services and designates Licensed Professional Counselors as Other Licensed Practitioners
