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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: Adds an assurance that the Department of Medical Assistance Services will make coverage and billing code modifications when the Advisory Committee on Immunization Practices (ACIP) and/or U.S. Preventive Services Task Force (USPSTF) “A” and “B” recommendations change. The amendment also makes a technical change to revise reference to section “4016” of the Patient Protection and Affordable Care Act to section “4106.”
Summary: DESCRIPTION: Proposes several changes to update, clarify, and streamline language in the state plan. The proposed changes include: 1) streamlining language that describes certain therapy modalities, which are available under the Counseling/Therapy service benefit, 2) updating supervision requirements for behavioral health providers in Federally Qualified Health Centers (consistent with District Law), 3) clarifying education and experience requirements for credentialed staff able to provide State Plan rehabilitative services, and 4) updating rates for select behavioral health services according to the fee schedule.
Summary: This amendment change will amend to include the Ambulatory Detoxification Program and to assign a reimbursement rate of $18.18 per 15-minute increment.
Summary: This amendment allows Medicaid to include Ambulatory Withdrawal Management with Extended On-Site Monitoring and will assign a reimbursement rate of $21.37 per 15-minute increment. This service is a part of the NC Medicaid 1115 Substance Use Disorder Waiver, aligns with The American Society of Addiction Medicine (ASAM) Criteria (2013 edition) and expands the Medicaid substance use disorder service array.
Summary: This amendment updates the Alternative Benefit Plan to provide authority to recognize Community Health Workers (CHWs) as Medicaid providers of necessary CHW services.
