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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: 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: 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.
Summary: The Centers for Medicare and Medicaid Services (CMS) received Oklahoma State Plan Amendment (SPA) OK-21-0022-B to migrate individuals currently being served in Health Homes to other care coordination models in the state.
Summary: Effective January 1, 2021, this amendment expands the provider types that can authorize home health plans of care and order durable medical equipment.
