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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 plan amendment implements community mental health center and substance use disorder agency inflationary rate increases appropriated by the state legislature during the 2021 legislative session
Summary: This amendment proposes to add medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. This letter is to inform you that New Jersey’s Medicaid SPA Transmittal Number #21-0003 was approved on September 23, 2021 with an effective date of October 1, 2020, until September 30, 2025, pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act.
Summary: Revises the qualifying criteria for traumatic brain injury or spinal cord injury addon payment for individuals residing in a nursing facility. In addition, it allows flexibility for individuals to qualify for this add-on payment in circumstances where completing an actual rehabilitation program is not appropriate.
Summary: This plan amendment updates the quality incentive payment methodology for providers by improving the Health Home composite measures and aligning the clinical outcome payment methodology to it.
Summary: Effective October 1, 2018, this amendment adds coverage of long term residential substance use disorder services, which would allow an individual to initiate and receive services to treat substance use disorders in a less intense care setting, to the state's alternative benefit plan (ABP).
Summary: Effective March 1, 2020, this amendment establishes coverage of COVID-19 vaccine administration and a reimbursement rate for COVID-19 vaccine administration for providers reimbursed on a fee-for-service basis.
