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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: 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.
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: 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: The SPA allows NJ to update the mental health and substance use disorder rates and fee schedule to more closely align with existing state rates currently paid by the Division of Mental Health and Addition Services.
Summary: This SPA proposes to bring Tennessee into compliance with the pharmacy reimbursement requirements in the Covered Outpatient Drug final rule with comment period (COD final rule) (CMS-2345-FC) (81 FR 5170) published on February 1, 2016.
