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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 SPA amends the Medicare-Medicaid Coordinated Plan (MMCP) Alternative Benefit Package (ABP) to reflect the MMCP's expanded geographic availability to forty-two (42) of Idaho's forty-four (44) counties. The coverage exceptions are Lemhi and Franklin Counties.
Summary: This SPA amendment is to amend the coverage language regarding medical or other remedial care provided by licensed practitioners to include Physician Assistants.
Summary: To amend the State Plan to amend Physical Therapy, Occupational Therapy, and Services for Individuals with Speech, Hearing and Language Disorders in order to establish coverage criteria, provider qualifications, service limitations and reimbursement methodology for Hippotherapy.
Summary: This SPA clarified Rural Health Clinic (RHC) encounter limitations and exceptions, clarified the provision of "other ambulatory services," and identified provider types and qualifications of who may provide RHC services.
Summary: This SPA clarified Federally Qualified Health Center (FQHC) encounter limitations and exceptions, clarified the provision of "other ambulatory services," and identified provider types and qualifications of who may provide FQHC services.
Summary: This SPA updates the Coordination of Benefits/Third Party Liability (COB/TPL) cost-effectiveness threshold amounts and makes adjustments to the trauma code editing protocols.
Summary: This SPA extends Medicaid coverage for an initial period of 12 months for low-income families who no longer qualify for Medicaid due to increased earned income or working hours from the caretaker relative's employment, or due to the loss of a time-limited earned income disregard.
Summary: Allows State to Add New Managed Care Contractors When Needed, to Allow for Integrated Healthcare Delivery in Select Areas of the State, and to Update the Pre-Print To Its Most Recent Version.
