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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the pharmacist dispensing fee from $10.48 to $10.77 per prescription.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to waive the requirement (for year 2023) that state notify enrollees, through an annual mailing, that one or more of their healthcare providers are now part of the state's Integrated Health Partnerships (IHP) program (as outlined in approved State Plan Attachments 3.1-A Page 79b2 and Attachment 3.1-B Page 78b2).
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to waive any signature requirements for the dispensing of drugs during the public health emergency (PHE) from March 13, 2020 through June 30, 2021.
Summary: CMS approves Minnesota's time-limited COVID-19 disaster relief proposal. Effective March 1, 2020 per Section 7.4 of the Minnesota State Plan, the Minnesota State Medicaid agency waives signature requirements for the dispensing of drugs during the Federal COVID-19 Public Health Emergency.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to correct the payment amount approved in SPA 21-0029 of $1000 to Agency Directed personal care providers and Consumer Directed Attendants who provided personal care, attendant care, respite care, or companion care services to members who receive services via EPSDT during the first quarter of state fiscal year 2022.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a temporary rate increase for personal care assistance services and intermediate care facilities for people with developmental disabilities.
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 implement a payment rate increases for inpatient hospital services including mental health, obstetrics, newborns, transplants, rehab, trauma and pediatric care. Additionally, payment rates for all deliveries are increased to cover the hospital’s costs of additional Department of Health requirements for newborn screening tests.
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 establish a new threshold for determining when to seek recovery of reimbursement from a liable third party for COVID-19 testing and associated laboratory services administered through public health agencies.
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 authorize a new payment method for Federally Qualified Health Centers and Rural Health Clinics, adjusts the RBRVS conversion factor used to set payment rates for professional services, and modifies requirements for private duty nursing services.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to provide a one-time $1,000 payment to personal care providers who provided services to members who receive services via EPSDT during the first quarter of state fiscal year 2022. The SPA also provides a temporary 12.5% rate increase for personal care, respite, and companion services provided via EPSDT from July 1, 2021 through December 31, 2021. Additionally, the SPA provides a temporary 12.5% rate increase for behavioral health, early intervention, private duty nursing (under EPSDT), addiction and recovery treatment services (ARTS), targeted case management, and home health from July 1, 2021 through June 30, 2022. The temporary 12.5% rate increases will not be subject to the state's 'lesser of' methodology to reimburse the lower amount of the amount billed or the state fee.
