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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: The purpose of this SPA is to update the Program of All-Inclusive Care for the Elderly (PACE) rate methodology in the South Carolina State Plan.
Summary: Adds coverage and payment provisions to the Ohio Medicaid state plan for lactation counseling services provided by dieticians. Coverage and payment for lactation counseling provided by dieticians is being added to assist with improving the health of the population and reducing future preventable causes of poor health, such as obesity, in infants. CMS supports this action because it will improve infant health overall
Summary: This SPA proposes to allow the Division of Medicaid (DOM) to 1) revise coverage and payment methodology for extended services for pregnant and post-partum women who are at risk of morbidity or mortality, 2) set the fees for extended services for pregnant women the same as those in effect on July 1, 2021, and 3) remove the five percent (5%) reimbursement reduction effective July 1, 2021.
Summary: proposes to add coverage language and requirements to targeted case management for the chronically mental ill to comply with 42 CFR §§ 440.169 and 441.18
Summary: Allows the Division of Medicaid (DOM) to set the fees for DPSDT extended services to the same as those in effect on July 1, 2020, to remove the five percent (5%) reimbursement reduction effective July 1, 2021, and add coverage and reimbursement of Mississippi Youth Programs Around the Clock (MYPAC) Therapeutic Services effective July 1, 2021.
Summary: Allows the state to transfer the administrative functions and responsibilities of personal care and respite Individual Provider (IP) management from the Department of Social and Health Services (DSHS) and Area Agency on Aging (AAA) staff to a single contracted CDE vendor, the Consumer Direct Care Washington, LLC.
Summary: Adds Medication Therapy Management (MTM) to Licensed Pharmacist Services under the Other Licensed Practitioner (OLP) benefit; remove the Treatment Authorization Request (TAR) requirement from Licensed Pharmacist Services; and updates the rate methodology for Licensed Pharmacist Services by adding rates for MTM
Summary: Allows Physician Assistants to bill independently for service, and further includes physician assistants within the payment rate of the other providers affiliated within the University of Utah Medical Group
