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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 January 22, 2021, this plan amendment updates the methods and standards used by Massachusetts to set payment rates for acute outpatient hospital services.
Summary: Effective January 1, 2021, this plan amendment updates the methods and standards used by Massachusetts to set payment rates for Home Health services.
Summary: Effective January 22, 2021, this amendment revises reimbursement for inpatient hospital psychiatric services. Specifically, it implements adult and pediatric supplemental per diem payments for the rate year 2021 performance period.
Summary: Effective effective October 1, 2020 until September 30, 2025, this amendment implements the time-limited mandatory medication assisted treatment benefit (MAT) per section 1006(b) of the SUPPORT Act to address opioid addiction. Section 1006(b) of the SUPPORT for Patients and Communities Act (SUPPORT Act), signed into law on October 24, 2018, amended section 1902(a)(10)(A) of the Act to require state Medicaid plans to include coverage of MAT for all eligible to enroll in the state plan or waiver of state plan. Section 1006(b) also added a new paragraph 1905(a)(29) to the Act to include the new required benefit in the definition of “medical assistance” and to specify that the new required benefit will be in effect for the period beginning October 1, 2020, and ending September 30, 2025.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to reimburse certain specifically listed clinical laboratory services, including COVID-19 specimen collection and testing, with updated fee schedules.
Summary: Effective January 1, 2021, this amendment adjusts the dental benefit to include crowns and certain endodontic services including root canals and apicoectomies as covered services for beneficiaries 21 years and older.
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 add additional payment methodologies for home health and private duty nursing services.
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 eliminate co-pays for a number of eligibility populations as well as a number of services.
Summary: Effective January 01, 2021, this amendment updates the optional state supplement program's annual income standards consistent with the federal register.
