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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: Add hospice attending physician service reimbursement rates to FQHC and RHC PPS rates. Section 132 of the Consolidated Appropriations Act, 2021 amended section 1834(0) of the Act and added a new section 1834(y) to the Act, to provide the authority for both FQHCs and RHCs, respectively, to receive payment for hospice attending physician services.
Summary: This amendment proposes revisions to bring Kansas' State Plan into compliance with recent guidance requiring states to assure necessary transportation for beneficiaries to and from covered services
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to establish coverage of prescribed drugs that are not covered outpatient drugs, including when the drug is authorized for import into the United States by the FDA, when the state determines coverage is medically necessary due to a recognized critical drug shortage.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a Direct Service Workers recruitment and retention bonus provision under 9817 American Rescue Plan Act of 2021.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to make Hospital APC payments for vaccine administration equals 100% of Maine Medicare rate; add/adjust reimbursement for medication management by Behavioral Health providers; implement a one-time supplemental payment of $23 million (inpatient $12.5 million/outpatient $10.5 million); implement a supplemental payment of $2,079,376 to Adult Family Care Services providers, add crisis services under behavioral health professional; and allow several providers to provide crisis services.
