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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 is to establish coverage for doula services as a new reimbursable preventative service for individuals navigating pregnancy-related care adding coverage for lactation provider services as a new reimbursable preventative to increase access to education and management to prevent and solve breastfeeding problems and encourage support to breastfeeding mother-infant.
Summary: This amendment is relating to an executive reorganization which will rename the Human Services Department (HSD) as the Health Care Authority (HCA). As a new executive department, HCA will administer laws and exercise functions relating to health care purchasing, policy, and regulation for the State of New Mexico.
Summary: Assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This plan amendment revises the reimbursement methodologies for Psychiatric Residential Treatment Facilities (PRTF) and hospital supplement payments for freestanding children's hospitals with greater than fifty percent Medicaid utilization.
Summary: This plan amendment removes obsolete language increasing the nursing facility per diem rate by $6.13 per day. That increase has now been absorbed into the standard per diem methodology and rates.
Summary: Disregards portions of Social Security Disability Insurance (SSDI) income when calculating financial eligibility for certain sections 1915(c) waivers.
