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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: Effective August 14, 2020, this amendment increases the reimbursement for ventilator dependent nursing facility residents. Specifically, this amendment proposes to increase the nursing facility per diem for a ventilator dependent resident by 3%. The rate will increase from $540.55 to $556.77.
Summary: Effective August 14, 2020, this amendment implements a quality incentive for nursing homes that receive national quality award status or accreditation.
Summary: Effective January 22, 2021, this amendment revises reimbursement for pediatric behavioral health services. Specifically, it increases supplemental payment by $30 per day for rate year 2021 performance period.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow the territory to consider individuals absent from the territory to continue to be residents; to provide rate increases for FQHC medical encounters rendered at government quarantine locations; to create payment methodology for local non-government dialysis centers in AS during the PHE period; to revise the payment methodology for off-island dialysis; and to revise payment methodology for transportation and related accommodations associated with return from off-island medical care.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to add pharmacists' services to other practitioners' services, to allow licensed pharmacists, pharmacy interns, and pharmacy technicians to administer COVID-19 vaccines, consistent with their scope of practice. Effective December 1, 2020, the state will pay a rate equivalent to the Medicare rate for administration of COVID-19 vaccines.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to authorize pharmacies, pharmacists, pharmacy interns, and pharmacy techs to administer the COVID vaccination under the preventive services benefit. The SPA also updates the reimbursement methodology for vaccine administration.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the COVID-19 vaccine administration payment rates to align with Medicare rates and allow other licensed practitioners such as pharmacists and pharmacy interns to administer the vaccine.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to reimburse certain specifically listed clinical laboratory services, including COVID-19 specimen collection and testing, with updated fee schedules.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to increase reimbursement for gloves used for in home services. Gloves provided as a medical supply for use in the home will be reimbursed based on 100% of the reimbursement by Blue Cross/Blue Shield of Arkansas.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to increase payments to Nursing Facilities and ICF/IIDs for infection control related expenses. It allows Nursing Facility cost reports to accommodate efficient vaccine distribution. It also identifies that indirect costs exclude COVID-19 vaccines where Medicaid reimbursement is available directly to a third party.