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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 amends the provisions governing Early and Periodic Screening and Treatment EPSDT personal care services in order to revise the recipient qualification to remove the criteria regarding personal/caregivers availability in the home.
Summary: The SPA proposes to adopt provisions to include an optional coverage group under the Medicaid State Plan to implement the State Provisional Medicaid Program which will provide interim Medicaid-only benefits to eligible individuals until such time that a decision has been rendered on their SSI cash assistance application pending with the Social Security Administration as per 1902(a)(IO)(A)(ii)(X) and 1902(m)(l) of the Social Security Act.
Summary: Revises the reimbursement methodology for rehab clinics in order to increase the rates for physical and occupational therapy services rendered to recipients under the age of 21.
Summary: This state plan amendment revises the provisions governing coordinated care networks to include pharmacy services as a covered service under the BAYOU HEALTH Program for recipients enrolled in pre-paid health plans.
Summary: This state plan amendment removes the provisions for dental services rendered to Medicaid eligible pregnant women in order to terminate the program as an optional covered service under the Medicaid State Plan.
Summary: This state plan amendment adds language to include additional substance abuse screenings for Medicaid eligible pregnant women in the event of miscarriage or fetal death within the 270 day pregnancy period. The plan also lists the LaHART system as the State's screening and assessment tool for these services.
Summary: Allows the State to implement immediate auto-assignment of pregnant women whose Medicaid eligibility is limited to prenatal, delivery, and post-partum services to the Bayou Health Program.
