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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 plan amendment purposes to reduce New Mexico's home equity limits for Medicaid coverage of long-term services and supports (LTSS) from $858,000 (the maximum amount permitted under law) to $572,000 (the minimum amount permitted under law).
Summary: This SPA is to remove Long Acting Reversible Contraceptives (LARC) from the Federally Qualified Health Centers (FQHC) PPSrate and reimburse the LARC under FFS.
Summary: This SPA is to remove Long Acting Reversible Contraceptives (LARC) from the Rural Health Centers (RHC) PPS rate and reimburse the LARC under FFS.
Summary: This SPA proposes to bring New Mexico into compliance with the pharmacy reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC) (81 FR 5170) published on February 1, 2016.
Summary: This Amendment corrects the State plan regarding the state's payment of Medicare Part A and B deductibles and cost-sharing on Medicare crossover claims.
Summary: This amendment re bases Nursing Facility and Nursing Facility for Mental Health payment rates for State fiscal year 2018. Payment rates will increase on average by 4. 76 percent. This SPA also updates charts and exhibits within the State plan that demonstrate the revised factors and limits applicable to the rate period beginning with SFY 2018.
Summary: This amendment updates the plan to reflect the State's current policy of allowing inpatient hospital interim bills for inpatient hospital stays that exceed 30 days.
Summary: This amendment reverses the 4.00% rate decrease that was applied to fee-for-service inpatient hospital payment rates other than Diagnosis Related Group (DRG) outlier payment rates on July 1, 2016 for all hospitals other than critical access hospitals, hospitals located in frontier, rural and densely settled rural counties, and state-operated psychiatric hospitals.
