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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: 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 adjust reimbursement methodologies.
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 update the reimbursement rates related to testing, prevention, and treatment of COVID-19.
Summary: CMS is approving this time-limited state plan amendment to
respond to the COVID-19 national emergency. The purpose of this amendment is to provide a supplemental payment of $15 per diem to eligible residents for services provided in nursing facilities and nursing facilities for mental health through a one time lump sum payment.
Summary: To address the COVID-19 public health emergency, in order to terminate prior authorization for medications expanded by automatic renewal without clinical review, or time/quantity extensions.
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 temporarily modify the provider recertification process for providers of 1915(i) state plan HCBS. This amendment allows the state to align the state's processes with the state's 1915(c) HCBS and Appendix K submissions.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment seeks to modify certain requirements of Title XIX of the Social Security Act to address the COVID-19 public health emergency, in order to increase the reimbursement for COVID-19 vaccine administration per dose.
Summary: Effective July 1, 2021, this amendment redefines the payment limit to eligible medical professionals of UNC Health Care and ECU Physicians from a unique count of eligible medical professional providers to an aggregate dollar cap in preparation for the North Carolina Medicaid Transformation to Managed Care.
Summary: Effective July 1, 2021, this amendment revises the methodology for calculating hospital specific Medicaid ratio of costs to charges (RCCs) in preparation for the North Carolina Medicaid Transformation to Managed Care. The amendment will also discontinue hospital outpatient supplemental payments, increase hospital RCCs, and define how to establish hospital RCC’s for new hospitals and changes of ownership.
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 provide allow for a temporary premium payment to be paid to specified providers for in-person care and modifying the timeframe for accepting long term care facility annual cost reports.
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 long-term care facilities licensed in Mississippi an add-on payment of $13.00 per day per beneficiary for claims for dates of service from January 1, 2021 through June 30, 2021.