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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 reinstate the reimbursement methodology for school-based rehabilitation service Comprehensive School and Community Treatment that was approved through December 31, 2019, for the time period March 1, 2020 through June 30, 2020.
Summary: Authorizes the District to enroll approximately 19,000 District individuals, who are currently assessing their benefits via fee-for-service, into Medicaid managed care
Summary: Updates the LTCSS assessment requirements for beneficiaries receiving PCA services to align with changes made to the District’s assessment process and corresponding regulations
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 temporarily modify the State Plan reimbursement methodology for FQHCs to establish a new alternative payment methodology (APM) as authorized in Section 1902(bb)(6) of the SSA.
Summary: Updates fee schedule reimbursement as of March 1, 2020 for targeted case management services: (1) Youth with Serious Emotional Disturbance (SED, (2) Youth with SED in an Out-of-State PRTF, (3) Adults with Severe Disabling Mental Illness, (4) Substance Use
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to expand Telehealth, adjustments to 1915(i) adult day health services, adjust day supply limits to allow and reimburse for dispensing of a 90-day supply of maintenance medications, waive physician authorization for LTCSS assessment and request for re-assessment, modify certain payment rates, and to modify the My Health GPS health home program to eliminate acuity tiers, face-to-face requirements, and update care team staffing requirements as well as modify reimbursement methodology.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, allow 90-day supplies of drugs and early refills, allow exceptions to the State's preferred drug list, allow use of telehealth service delivery methods in lieu of face-to-face when appropriate, and to establish supplemental payments for NF/ICF providers.
