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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 time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover testing in non-office locations; provide lab coverage for self-testing; and increase bed hold/therapeutic absence days for nursing facilities and intermediate care facilities for individuals with intellectual disabilities to 60 days per calendar quarter.
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to expand Telehealth, adjustments to 1915(i) adult day health services, adjust day supply limits to allow and reimburse for dispensing of a 90-day supply of maintenance medications, waive physician authorization for LTCSS assessment and request for re-assessment, modify certain payment rates, and to modify the My Health GPS health home program to eliminate acuity tiers, face-to-face requirements, and update care team staffing requirements as well as modify reimbursement methodology.
Summary: Adds Orange County (Group 4) to the existing Health Home Program with the population criterion of Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED)
Summary: update the home health services fee schedule by increasing the rates by one percent (1 %) for Health Care Procedural Coding System (HCPCS) codes Tl00 4 (Services of a qualified nursing aide, up to 15 minutes) and Tl021 (Home Health aide or certified nurse assistant, per visit) provided by licensed home health agencies.
Summary: Creates a new Targeted Case Management State Plan program for Public Health Nurse Home Visiting targeting Medicaid eligible infants through 6 months of age in Lincoln County.
