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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: This amendment removes Prior Authorization Request requirements for Home Health Services. Additionally, the SPA allows practitioners to order and re-order that the patient is eligible for Medicaid Home Health Services.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend the suspension of premiums for the state's Work Incentives group under section 1902(a)(10)A)(ii)(XIII) of the Act.
Summary: Chronic Care Management for Individuals with Serious and Persistent Mental Health Conditions to expand the Behavioral Health Home to more geographic areas and update staffing requirements to allow flexibility for the required provider infrastructure.
Summary: To add an assessment fee to the Health Home program to ensure that any child who may be eligible for Home and Community-Based Services (HCBS) under the Children's Waiver, demonstration or State Plan authority will be eligible to receive an HCBS assessment under the Health Home program.
Summary: This SPA adds conforming updates in state law, including commissioner authority to grant variance of behavioral health home service provider requirements; clarification of provider requirements and expectations; corrects the list of qualified positions for a Qualified Health Home Specialist, and adds requirement for Behavioral Health Home (BHH) providers to notify the contact designated by an enrollee’s managed care plan within 30 days of the start of BHH services.
Summary: This amendment is to comply with federal requirements on premium and cost sharing tracking and assessing copays on non-emergency use of services provided in emergency departments. This amendment proposes to eliminate copayments in the Medi-Cal program effective July 1, 2022.
Summary: This Amendment increases the cost-sharing imposed for non-emergency use of a hospital’s emergency department from $6 to $8, in accordance with the 2022 Colorado General Assembly Long Bill (House Bill 22-1329).
