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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: Adopt provisions governing medication-assisted opioid use disorder (OUD) treatment in opioid treatment programs, for Medicaid-eligible recipients ages 18 and over, diagnosed with OUD
Summary: This SPA amend the provisions governing therapeutic group homes (TGH) in order to reflect the coordinated system of care (CSoC) contractor moving from a non-risk contract to a full-risk capitated contract and to reflect that TGH are carved out of management by the CSoC contractor to align with current practice and contract requirements.
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: 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.
Summary: This state plan amendment proposes to amend the provisions governing laboratory and radiology services to terminate coverage and reimbursement for proton beam radiation therapy rendered to recipients 21 years of age and older.
Summary: Revises the provisions governing Rural Health Clinics (RHCs) in order to allow certified medical assistants to apply fluoride varnish under the direction of a certified physician, and to establish training requirements for appliers of fluoride varnish.
Summary: Adopts the provisions to establish a Medicaid Asset Verification program to verify the assets of aged, blind or disabled applicants for, and recipients of, Medicaid benefits.
