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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: Effective March 31, 2021, this amendment removes a limit for psychiatric hospitalization that prevented more than 21 days in a hospital in a 60-day period for the same or similar diagnosis or treatment plan and updates practitioner terminology as it relates to working titles.
Summary: The purpose of this SPA is to update the ARTS state plan pages to incorporate general updates to the program, including updates related to medication assisted treatment, defining the scope of practice for certified substance abuse counselors, including substance use disorder counseling within that scope, and guidance related to telemedicine requirements.
Summary: The purpose of this SPA is to amend the state plan to allow nurse practitioners, clinical nurse specialists, and physician assistants to order and certify home health services.
Summary: increase the number of covered inpatient rehabilitation hospital days for adult SoonerCare members from 24 days per state fiscal year to 90 days per state fiscal year
Summary: Separates and differentiates between services provided in a school setting under EPSDT versus those school-based services provided pursuant to an Individual Education Plan (IEP).
Summary: This SPA allows a nurse's license to be portable between member states of the compact to increase access to care by allowing nurses to practice in other states without obtaining additional licenses
Summary: To include pancreas and intestinal transplants as covered organ and tissue transplant procedures. It also updated transplant standards to include donor search and procurement services and to ensure that the methods used for organ acquisition are consistent with the Medicare program
Summary: Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
