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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 for services on or after February 20, 2022, this SPA amends the provisions governing reimbursement for nursing facilities in order to establish guidelines for submitting amended cost reports and to ensure that costs in the rate and floor component are classified appropriately.
Summary: This amendment was submitted in order to update the Medicaid fee schedule to include the rate increase for adaptive behavioral treatment by Behavioral Therapists.
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 daily per diem rate paid to privately owned or operated nursing facilities and include a direct care add-on to reimburse ICF-IID for increased cost related to retaining and hiring direct care staff.
Summary: The state proposes to include assurances that the state complies with Third Party Liability rules as authorized under both the Bipartisan Budget Act of 2018 and the Medicaid Services Investment and Accountability Act of 2019. The state has submitted this SPA per the guidance issued in August 2021. CMS supports this change.
Summary: This SPA amended the provisions governing Rural Health Clinics (RHCs) in order to establish that where payment(s) from managed care organizations (MCOs) are less than the amount the RHC would be entitled to receive under the Prospective Payment System (PPS) or alternative payment methodology (APM), the RHC will be eligible to receive a wrap-around supplemental payment processed and paid by the Louisiana Department of Health.
Summary: To include assurances that the state covers routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries, who receive benefits through the alternative benefit plan, in qualifying clinical trials.
Summary: The state proposes to include an assurance that the state covers routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials.
