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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: Ensures Non-Emergency Medical Transportation's (NEMT) provider and driver requirements are satisfied and add to the Alabama Medicaid Agency's State Plan as a statutory requirement for the assurance of transportation under Title 42 CFR § 431.53.
Summary: Allows the Alabama Medicaid Agency to apply the reimbursement basis for inpatient and outpatient hospital services for State fiscal year 2022 (Medicare and cost, respectively) used in fiscal year 2021 including an adjustment to utilization trends impacted by COVID-19.
Summary: Effective April 1, 2021, this amendment adds the optional eligibility group described at section 1902(a)(19)(A)(ii)(XXII) of the Social Security Act to the Alabama state Medicaid plan (the "Individuals Receiving State Plan Home and Community-Based Services group," or "219(a) group").
Summary: This amendment will allow for Case Management Services to be billed for High Intensity Care Coordination for each eligible recipient in the family, each month, according to each recipient’s unique needs.
Summary: Updates the Alabama Coordinated Health Network (ACHN) Quality Bonus Payment date from July 2021 to October 2021, effective March 1, 2021. The reason for the change is to allow enough run time for historical claims data.
Summary: Effective July 1, 2020, this amendment allows the disregard of Census-based income for certain Non-Modified Adjusted Gross Income (non-MAGI) eligibility groups.
Summary: This SPA adopts the option to provide Medicaid eligibility without a 5-year waiting period to otherwise eligible individuals who lawfully reside in Guam in accordance with the Compacts of Free Association (COFA) between the Government of the United States and the Governments of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau
Summary: This SPA incorporates the current version of the Program of All-Inclusive Care for the Elderly (PACE) State Plan Amendment preprint and provide State assurances that PACE rates are set at less than 100% of the amount that would otherwise have been paid for a comparable population.
Summary: Effective January 1, 2021, this amendment increases the local poverty level (LPL) such that the MAGI income standards of 138% of the LPL is equivalent to 150 percent of the federal poverty level (FPL).
