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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: On March 31, 2022, the Centers for Medicare and Medicaid Services (CMS) received Montana State Plan Amendment (SPA) MT-22-0002, in which the state proposed to increase the general income disregard for medically needy individuals from $100 to $269 per month, and to further modify the disregard consistent with Social Security Administration cost-of-living adjustments beginning in 2023 and in subsequent years.
Summary: This amendment modifies the reimbursement received at an Indian Health Services or Tribal 638 provider for a Medicaid member with dual eligible benefits. The Medicare payment will be treated as third party payments and be offset against the all-inclusive Medicaid payment.
Summary: This amendment establishes compliance with mandatory Medicaid coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials in the Alternative Benefit Plan.
Summary: This amendment assures that Kansas will cover the mandatory benefit for costs of routine services related to participation in clinical trials in the state plan.
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 temporarily adjust staffing requirements, including staffing structure and required number of team members, for Montana Assertive Community Treatment and Program of Assertive Community Treatment to ensure services remain available.
Summary: This amendment proposes to add optometrist services to the prospective payment system (PPS) rates for Federally Qualified Health Centers (FQHC) and Rural Health Centers (RHC).