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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: Chronic Conditions Health Home - Managed Care Implementation to reflect the change in the Chronic Condition Health Home Informational Only Code for Comprehensive Transitional Care from G2065 to 99429. There were no other programmatic or reimbursement methodology changes observed.
Summary: This amendment is to temporarily increase rates of payment for Assertive Community Treatment (ACT) services as a component of Rhode Island’s 9817 plan implementation.
Summary: To allow enrollees to also be enrolled in Managed Care for their acute medical care needs, where in previous years they had been carved out into Fee for Service Medicaid.
Summary: The purpose of this state plan amendment is to add Community-Based Care Management (CBCM) Services by Opioid Use Disorder Centers of Excellence (COEs).
Summary: Maine State Plan Amendment (SPA) ME-22-0018 for Opioid Health Home (OHH) to establish a tier of services within the OHH program specific to perinatal care teams. These services with the OHH program are referred to as the Maine MOM (Perinatal OUD Care).
Summary: This SPA was approved to add sickle cell disease as a single qualifying condition for Health Homes Serving Adults and Health Homes Serving Children.
Summary: Updates the Primary Care Physician Consultant to the Specialized Healthcare Consultant, allowing Health Homes flexibility in offering additional consultation from a variety of healthcare professions for special populations. Also updates the Per Member Per Month (PMPM) payment for Community Mental Health Centers (CMCH) Health Homes.
