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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: Establish coverage and reimbursement for alternative treatments for pain management under the rehabilitative services benefit. This new optional service for adults will help Medicaid beneficiaries with chronic pain reduce reliance on opioid medications to manage their pain.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to enable federally qualified health centers (FQHC) and rural health clinics (RHC) to be reimbursed outside of the established, all-inclusive prospective payment system (PPS) rate for administration of the COVID-19 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 to add vaccine administration for homebound beneficiaries under the preventive services benefit, including a brief health screening, in addition to administration of the COVID vaccine, and to add a reimbursement methodology to those services.
Summary: Updates the bundled composite rate for services provided in an outpatient maintenance dialysis clinic. The Dialysis Clinic reimbursement rate will be increased by 1%.
