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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: This SPA is to amend the provisions governing Targeted Case Management (TCM) under the New Opportunities Waiver (NOW), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), and EarlySteps programs in order the clarify language and ensure the requirements for TCM services are accurately reflected throughout the State Plan.
Summary: This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Summary: The purpose of this SPA is to amend the provisions governing payments for well baby and transplant services, within the inpatient hospital services program, in order to align with current practices.
Summary: The purpose of this SPA is to amend the provisions governing the Pharmacy Benefits Management program in order to remove references to specific over-the-counter (OTC) drugs that are covered under the State Plan.
Summary: The purpose of this SPA is to amend the standards for payment and reimbursement for nursing facilities in order to implement the patient driven payment model for case-mix classification and mandate use of the optional state assessment item set.
Summary: This amendment is to include new resource disregards in its state plan for purposes of determining financial eligibility for certain Medicaid eligibility groups.
Summary: The purpose of this SPA is to amend the provisions governing disproportionate share hospital (DSH) payments to increase reimbursement for DSH eligible services provided by hospitals through a cooperative endeavor agreement with the Office of Behavioral Health(OBH), in order to align the rate for OBH approved DSH days with the Medicaid inpatient psychiatric per diem rate on file for freestanding psychiatric hospitals.
Summary: This SPA proposes to reimburse clotting factors using the Louisiana clotting factor average acquisition cost (AAC) and a unit based professional dispensing fee reimbursement methodology.
Summary: The purpose of this SPA is to amend the provisions governing midwifery services in order to increase the reimbursement rate for services provided by certified nurse midwives and licensed midwives.
