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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 amendment updates inpatient acute hospital payment methods and standards. The amendment also authorizes supplemental payment to qualifying acute hospitals and establish payment rates for new behavioral health and substance abuse use disorder services rendered in the hospital. Additionally, this amendment sunsets the state's pay-for -performance program but continue new incentive payment previously approved under the stat's clinical quality incentive program and its hospital quality and equity incentive program.
Summary: The purpose of this SPA is to amend provisions governing medical transportation services in order to link emergency medical transportation to the Louisiana Medicaid fee schedule.
Summary: This amendment is to cover adult vaccines approved by the U.S. Food and Drug Administration (FDA) and administered in accordance with recommendation by the Advisory Committee on Immunization Practices (ACIP), and their administration, without cost sharing.
Summary: The purpose of this SPA is to revise the provisions governing Outpatient Hospital Services in order to establish quarterly supplemental payments for certain public non-state small rural hospitals located in administrative region 3 that render qualifying services during the quarter.
Summary: This SPA is to amend the provisions governing Targeted Case Management (TCM) under the New Opportunities Waiver (NOW), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), and EarlySteps programs in order the clarify language and ensure the requirements for TCM services are accurately reflected throughout the State Plan.
Summary: This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
