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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 amendment allows provisions governing the Pharmacy Benefits Management Program to update the copay tier payment schedule to align with the U.S. Department of Health and Human Service, CMS, recommended guidelines.
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 cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
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 cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
Summary: Amends the provisions governing the reimbursement methodology for Federally Qualified Health Centers (FQHCs) in order to implement an alternative payment methodology to allow FQHCs to be reimbursed a separate perspective payment system (PPS) rate for behavioral health and dental services.
Summary: Revises the provisions governing the Professional Services program 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: Amends the provisions for Federally Qualified Health Centers (FQHCs) to allow certified medical assistants to apply fluoride varnish under the direction of a physician and to establish training requirements for the applier of fluoride varnish.
Summary: This amendment increases the allowable cost of the provider tax that can be recognized for reimbursement purposes from $14.30 to $16.15 per day, for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).
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: The purpose of this amendment is to revise the method of evaluating the cost effectiveness of the Louisiana Health Insurance Premium Payment Program (LaHIPP).
