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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: Added a new 1915(i) Home and Community-Based Services (HCBS) benefit, transmittal number NC-22-0026, titled Mental Health/Individuals with Developmental Disabilities/Substance Use Disorder (SUD).
Summary: This amendment proposes to update the Alternative Benefit Plan population, voluntary benefit package selection process and the process for exempting members from mandatory enrollment.
Summary: The state adds the target group of 0 through age 5 and clarifies needs-based criteria language to the High-Risk Children with SED HCBS benefit.
Summary: State is increasing the rates for the following 1915(i) services: peer support, family peer support, and training and supports for unpaid caregivers. Other revisions to the state plan include modifications to the requirements of care coordinators, individual provider qualifications for the housing support service, and the quality remediation process for quality measures in the state plan.
Summary: State is amending the Community First Choice (CFC) program to add an option that allows level of care assessments to be completed remotely when an in-person visit is not possible and also adds language that allows participants and providers to finalize the person-centered plan with an electronic signature.
Summary: This Alternative Benefit Plan amendment is to add coverage and reimbursement of community violence prevention services performed by certified violence prevention professionals as a new benefit.
