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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 time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend cost sharing for testing services, testing-related services, and treatment for COVID-19 (including vaccines, specialized equipment and therapies); Suspends premiums for Working Disabled and TMA; Allow Home health to be ordered and plans of care authorized by new provider types (Nurse Practitioner, Physician Assistant, Clinical Nurse Specialist; and Nurse Midwife); Increase the NF bedhold to 90 days provided the bed has not been filled; Add teledentistry reevaluation - post operative visit; and add codes and rates for teledentistry services added.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend all cost sharing for all eligibility groups effective May 1, 2020, through the remainder of the public health emergency.
Summary: Updates the rates for Licensed Practical Nursing (LPN) private duty nursing services provided by a home health agency and adds more comprehensive language describing the reimbursement methodology for Extended Home Health Services.
Summary: To remove the maximum number of chiropractic visits for adults and children; to base the need for chiropractic treatment on medical necessity; and to allow coverage guidelines for treatment more consistent with the licensure scope of practice for chiropractors
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover individuals evacuated from the state or absent due to disaster, extend the reasonable opportunity period, designate new populations for presumptive eligibility to be determined by qualified entities who previously determined presumptive eligibility for Pregnant women only expanded telehealth to specific named providers; to provide new rates and billing codes for telehealth services, and provide new test codes and rates.
Summary: Adds an additional disregard from resources to exempt land or assets held as a life estate when the life tenant cannot sell the asset without agreement from the remainder interest holders for the following eligibility groups subject to 1902(r)(2) of the Act: Medicare Savings
