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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: 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: Effective July 1, 2021, this amendment updates Oklahoma's Alternative Benefit Plan (ABP) to remove the 24-day visit limitation for inpatient physician services, adds Medication Assistive Treatment (MAT) services, and enhances dental services for adults.
Summary: This SPA was submitted to annotate that the state requires providers to bill liable third parties when services covered under the Plan are furnished to a member on whose behalf child support enforcement is being carried out
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: 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 align the Expansion Adult ABP with previously approved Disaster Relief SPAs.
Summary: This state plan amendment amends the reimbursement methodology for federally qualified health centers (FQHC) to separate reimbursement for long-acting reversible contraceptive (LARC) devices from the encounter rate.
Summary: Effective the day after the Public Health Emergency (PHE) ends, this amendment revises the providers that can order home health services. In addition to physicians, the amendment allows nurse practitioners, clinical nurse specialists, or physician assistants, working in accordance with State law, to order home health services to comply with federal regulation.
Summary: Effective September 1, 2021, this amendment modifies the Other Licensed practitioner benefit to allow licensed psychologists to render applied behavior analysis (ABA) services within state scope of practice without previous ABA related national certification requirements. This action will allow additional state licensed psychologists to provide services within state scope of practice, permissible under the OLP benefit and will likely increase the provider pool, which would be beneficial to Medicaid eligible children with autism.
