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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to extend the 5% increase in payment rates for ODDS services and settings for the period 7/1/22 through 9/30/22 or until the end of the PHE, whichever is first.
Summary: This SPA approves the continuation of reimbursement for telehealth services after the end of the Public Health Emergency as established under the Disaster Relief SPA TN No. 20-0006
Summary: The purpose of this amendment is to comply with the American Rescue Plan (ARP) Act of 2021 that requires coverage of COVID-19 vaccines, testing, treatment, and treatment of a condition that could complicate the treatment of COVID-19 in Medicaid.
Summary: This amendment complies with the requirements for assurance of Medicaid coverage for non-emergency medically-related transportation in accordance with Section 209 of the Consolidated Appropriations Act of 2021.
Summary: Adjust the reimbursement methodology for nursing facilities to align with the Medicare Patient Driven Payment Model (PDPM), incentivize quality care and staffing levels, and include a $70 million annual quality incentive payment tied to Long Stay STAR ratings.
