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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: Removes references to “broker” or “brokering from the description for non-emergency transportation (NEMT). NE no longer directly brokers with transportation providers for services. For beneficiaries receiving their Medicaid through Managed Care, NEMT services have been added to the MCO contracts as of July 1, 2019. NE will reimburse NEMT fee for service for all other Medicaid beneficiaries
Summary: Amend the provisions governing the enrollment choice period for Medicaid beneficiaries enrolled in a Managed Care Organizations, from a 90-day period to a minimum of 30 days.
Summary: Modify and clarify the provisions of the Medicaid State Plan with regards to personal care services and to self-directed personal assistance services.
Summary: Amends Idaho's Medicare-Medicaid Coordinated Alternative Benefit Plan (MMCP ABP) to add the Medicaid Plus program, which is an MMCP ABP managed care delivery system .
Summary: Revises the current inpatient hospital 30-day re-admission policy to exclude re-admissions that are planned for repetitive or staged treatments.
