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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 SPA adds coverage of select prescribed drugs that are not covered outpatient drugs, and also adds coverage of prescribed drugs that are not covered outpatient drugs in cases of a drug shortage.
Summary: To update the fees of health home serving children care management and add an additional tiered fee for health homes serving children providing High Fidelity Wraparound (HFW) as an evidence-based care management service provided to children/youth referred and eligible for HFW within Health Homes Serving Children, by agencies designated by the New York State designation process.
Summary: Memorialize changes made during the COVID-19 Public Health Emergency to the My Health GPS Health Home Program. Modifications to the My Health GPS Program include changes to staffing ratios, provider payment reimbursement methodologies, and administering the needs assessment portion of a beneficiary's level of care review.
