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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: Revision for the adult day health services provided to individuals with physical and cognitive impairments who do not meet a nursing home level of care.
Summary: Implements Health Homes for Opioid/Substance Use Disorder targeted conditions as authorized under Section 2703 of the Patient Protection and Affordable Care Act.
Summary: Requirements for (1) a face-to-face visit with a physician or authorized non-physician practitioner prior to the initiation of home health visits or provisions of durable medical equipment (DME) and appliances, (2) the provision of home health services in any setting which normal life activities take place, and (3) revises the definition of DME to comply with the Medicaid Home Health Final Rule.
Summary: This SPA provides Behavioral Health Home Services to children under the age of 21 in Bergen County by enhancing the current care management team within the Care Management Organizations.
