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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: NH entered into a contract with a new broker for non-emergency medical transportation. This amendment is being submitted to specify in the State Plan that effective May 1, 2022, the state changed the reimbursement methodology from a per member per month risk capitated rate.
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 allow for a mechanism to make provider payments to be used for workforce investment for direct care HCBS workers and is a component of New Hampshire's HCBS Spending Plan.
Summary: This SPA expand passive enrollment of the Medicare-Medicaid Coordinated Alternative Benefit Plan to three additional counties where there is only one participating health plan.
Summary: This amendment revises the supplemental payment methodology to Nursing Facilities (NFs) for state fiscal year (SFY) 2022. Specifically, Idaho Medicaid will utilize a one-year NF Patient-Driven Payment Model (PDPM) Upper Payment Limit (UPL) methodology to distribute supplemental payments to qualifying providers.
Summary: New Hampshire clarifies that the state appropriately covers and pays for routine patient costs of items and services for beneficiaries enrolled in qualifying clinical trials, as newly required under amendments made by Section 210 of the CAA. NH provides coverage for these costs already—no new items or services are being covered, and no payment methodologies are being changed.