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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 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: update the benchmark plan for the ABP for the New Adult Group. This is being updated to a 2014 base benchmark plan pursuant to 45 CFR §156.110. The ABP delivery model summary is also being updated based on the approved 1115 Global Commitment to Health waiver. This SPA was approved June 10, 2021 with an effective date of January 1, 2017.
Summary: Effective January 1, 2021, this amendment expands the provider types that can authorize home health plans of care and order durable medical equipment.
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 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: Increases the Current Asset Value for Nursing Facilities to account for the increased costs of Nursing Facilities and to provide parameters for the Quality Incentive Add-on Payment to Nursing Facilities.
Summary: The amendment change the benefit for EPSDT recipients to two eye exams and two pairs of eyeglasses every calendar year and to change the eye exam and glasses benefit for recipients 21 years of age and older to one per two calendar years.
