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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: Implementation of NJ Family Care 1115 Demonstration Waiver as it pertains to guardian commission associated with personal needs allowance in the post eligibility treatment of income.
Summary: Amends the provisions governing home health services in order to comply with U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) regulations regarding face to face encounters, to clarify the provisions governing home health settings, and to remove the visit limit for adult recipients in order to align services with those received by the Medicaid expansion population.
Summary: This state plan amendment proposes to amend the provisions governing inpatient hospital services in order to repeal provisions requiring pre-admission certification, concurrent review and length of stay.
Summary: Amends the provisions governing family planning services to remove the limitation on office visits for physical examinations for family planning and family planning-related services.
Summary: Amends the provisions governing Express Lane Eligibility (ELE) by removing certain agencies from the eligibility determinations process, in compliance with the requirements of the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services.
Summary: Updates the methodology NJ uses to calculate the amount would otherwise paid (A WOP) for Program for All-Inclusive Care for the Elderly (PACE) rates to comply with NJ moving to managed care long term care (L TC).
Summary: This state plan amendment proposes to include applied behavior analysis-based therapy in the specialized behavioral health services provided by Managed Care Organizations (MCOs) in the Healthy Louisiana program.
