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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: This revises reimbursement for inpatient hospital services. Specifically it: 1) adds reimbursement for Long Active Reversible Contraceptives (LARC) during postpartum inpatient hospital stay to provide adequate reimbursement to provider for the device; 2) changes data used to calculate Prospective Interim Payment (PIP) to provide more accuracy; and 3) further revises the state's fourteen day readmission protocol which was approved under TN 14-0003 and further amended under TN 15- 0010.
Summary: This is for elimination of retrospective cost settlements and establish prospective payment rates effective October 1, 2012 for Mental Health Clinic services, Special Needs Transportation services, Family/Early Intervention services, and Preventive Services for Primary Care Enhancement services.
Summary: This amends the State's approved Title XIX State Plan to update telehealth and telemonitoring in the Medicaid State Plan. This SPA is estimated to have no Federal budget impact.
Summary: This SPA provides for the following: adding one private nursing facility to receive a supplemental payment to cover the cost of a mandatory evacuation of patient due to a hurricane; add coverage of Non-Emergence Medical Transportation (NEMT) to nursing facility services; provide an add-on to the per diem rate to pay for the NEMT services; and eliminate the occupancy required for replacement facilities for the first six months of operations.
Summary: UPDATED 11/17/2020 - The approved page inadvertently contained a typographical error in describing Private Duty Nursing Level IV reimbursement at $11,570 per month—the correct reimbursement amount of $1,570 per month is included in the attached pages. The official approval date remains May 24, 2018.
Summary: The purpose of this plan was to comply with 42 CFR 441.18(a)(8) which requires states to submit a separate SPA for each Targeted Case Management (TCM) group when the TCM services differ in terms of provider qualification, services, or methodology under which case management providers would be paid.
