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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 time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, suspend the resource test in determining eligibility for certain eligibility groups, add presumptive eligibility (PE) for certain eligibility groups, suspend premiums for certain individuals, expand telehealth, extend all prior authorization for medications by automatic renewal without clinical review or time/quantity extensions, allow the state to make exceptions to its published Preferred Drug List if drug shortages occur, and increase certain payment rates.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover individuals evacuated from the state or absent due to disaster, extend the reasonable opportunity period, designate new populations for presumptive eligibility to be determined by qualified entities who previously determined presumptive eligibility for Pregnant women only expanded telehealth to specific named providers; to provide new rates and billing codes for telehealth services, and provide new test codes and rates.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow cover the new optional group for COVID testing; apply less strict resource and income methods when determining eligibility for certain individuals; consider individuals evacuated from the state due to the emergency to continue to be residents; provide medical coverage to non-residents who are quarantined in the state due to COVID-19; allow hospitals to make presumptive eligibility decisions for certain individuals; suspend enrollment fees and premiums for all individuals; expand telehealth; add certain benefits and increase some payment rates related to the COVID-19 national emergency.
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 cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
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 cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
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 allow provider contact with Medicaid beneficiaries to be conducted via telehealth for Targeted Case Management Services.
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 allow the following rehabilitative providers to provide services via telehealth, including via telephone: Alcohol and drug counselors, alcohol and drug counselor temps, recovery peers, student interns, mental health certified peer specialists, mental health certified family peer specialists, mental health rehabilitation workers in ARMHS, and mental health behavioral aides operating in CTSS programs.
Summary: Updates neonatal services language in response to the MDHHS Fiscal Year 2020 budget, increasing the Medicaid reimbursement percentage from 75% to 95% for specified neonatal intensive and critical care services.
