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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: The purpose of this amendment is to establish an Alternative Payment Methodology for tribal health facilities that agree to enroll as a Tribal Federally Qualified Health Center (Tribal FQHC).
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this SPA is to provide authority to address the National Emergency to allow Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), Tribal FQHCs, and Tribal Health Centers (THC) to be reimbursed for COVID-19 specimen collection when no other eligible qualifying clinic visit is provided on the same date of service. The State of Michigan is also requesting authority to allow for COVID-19 laboratory specimen collection to be reimbursed when provided by a licensed Pharmacist or Pharmacy Technician under the supervision of a Pharmacist as authorized by the State within their scope of practice.
Summary: Authorizes 100% FFP for services provided by non-IHS/Tribal providers to Medicaid-eligible individuals who are Tribal Medicaid beneficiaries when the provider has a written care coordination agreement with an IHS/Tribal facility.
Summary: Revising the Community First Choice (K-Plan) option which increases the local case management benefit limit on assistive technology, implements an enhanced Foster Care model which would allow for some children with intellectual and developmental disabilities to be diverted from children's residential placement to less costly and restrictive placements, adds Support Technology where advanced supervision is necessary.
Summary: Clarifying the maximum amount paid for Medicare Part B coinsurance and deductibles for services provided by the Indian Health Services and tribal providers operating under 638 agreements.
Summary: Expands Health Homes into 8 additional counties with 7 providers. Will pilot a high fidelity wraparound model with 2 providers for children/adolescents. One provider will be first Tribal Health Home.
Summary: This amendment implements policy that health care facilities operated by Indian Health Service/Tribally-Operated 638 Health Programs/Urban Indian Health Programs (ITU) providers are designated as Federally Qualified Health Centers (FQHC).
Summary: This amendment clarified and simplified the rules for when the Indian Health Service (IHS) encounter rate is paid to IHS and triba facilities.
