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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 SP A is to amend the provisions governing the federal medical assistance percentage (FMAP) to establish a proxy methodology to account for the proportion of medical assistance expenditures for beneficiaries receiving extended postpartum coverage.
Summary: This amendment proposes to revise the North Carolina Point of Sale reimbursement policies and titles, and to allow North Carolina licensed and certified clinical pharmacist practitioners to administer services within the scope of their practice.
Summary: Effective January 1, 2021, this amendment increases Personal Care Services Medicaid rates by ten percent (10%) above the rate in effect. This increase is mandated by Section 12006 1903(l) of the 21st Century CURES Act.
Summary: Effective January 01, 2021, this amendment adds substance use disorder (SUD) as an additional eligibility criterion for Health Home Services. For payments made to Health Homes providers for Health Homes participants who newly qualify based on the Health Homes program’s additional condition coverage under this amendment, a medical assistance percentage (FMAP) rate of 90% applies to such payments for 8 quarters from the effective date of this SPA. The FMAP rate for payments made to health homes providers will return to the state's published FMAP rate at the end of the enhanced match period.
Summary: The purpose of this State Plan Amendment is to comply with the federal 21st Century CURES Act which requires states to implement electronic visit verification for personal care services by January 1, 2021.
