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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 July 1, 2018 this amendment provides reimbursement of graduate medical education cost attributable to individuals in managed care for State fiscal year 2019.
Summary: Effective July 1 2018 this amendment will provide a separate reimbursement rate for care and services fornishcd in licensed distincl units that provide specialized hospital-based psychiatric services dedicated solely to the treatment of persons aged 18 and older.
Summary: Eliminates DSH Health Relief Subsidy Fund payments (ii) revises the inpatient hospital supplemental Hospital Relief Subsidy Fund (HRSF) and Graduate Medical Education (GME) supplement payment allocation methodologies and amounts, and (iii) effective October 1, 2012 sunsets all hospital supplemental payments, as required by Special Terms and Conditions #9l(c) of the New Jersey 1115 Waiver.
Summary: Reimbursement for Advance Care Planning (ACP) visits to reimburse consistently with a percentage of the Medicare reimbursement policy based on date of service.
Summary: Updates service descriptions and adds new rehabilitative services for Medicaid-eligible recipients with mental illness, substance use disorder, or co-occurring mental illness and substance-use disorder diagnoses.
Summary: Through this SPA, Alabama implements mental health parity requirements in section 2103(c)(6) of the Social Security Act (the Act) and regulations at 42 CFR 457.496 to ensure that financial requirements and treatment limitations applied to mental health (MH) and substance use disorder (SUD) benefits are no more restrictive than those applied to medical/surgical (M/S) benefits.
Summary: This is submitted to revise the approved Title XIX State plan to describe changes to the reimbursement methodology for continuous skilled nursing services provided by home health agencies.
Summary: Expands Health Homes into 8 additional counties with 7 providers. Will pilot a high fidelity wraparound model with 2 providers for children/adolescents. One provider will be first Tribal Health Home.
