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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: Revises the qualifying criteria for traumatic brain injury or spinal cord injury addon payment for individuals residing in a nursing facility. In addition, it allows flexibility for individuals to qualify for this add-on payment in circumstances where completing an actual rehabilitation program is not appropriate.
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 remove the limit on the number of home and hospital bed leave days for which an ICF/IID can be paid in order to reserve the beds for when the individuals are able to return to the ICF/IID. This SPA also rescinds the flexibility approved in SPA CT-20-0015 that allowed PNMIs for adults to conduct only one random-moment time study (RMTS).
Summary: Effective July 1, 2021, this amendment allows for 12-month contraception dispensing and participation in the National Medicaid Pooling Initiative (NMPI).
Summary: Effective July 1, 2021, this amendment updates Oklahoma's Alternative Benefit Plan (ABP) to remove the 24-day visit limitation for inpatient physician services, adds Medication Assistive Treatment (MAT) services, and enhances dental services for adults.
Summary: Effective October 1, 2020 until September 30, 2025, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Summary: Effective July 1, 2021, this amendment increases the annual maximum for the adult preventive dental benefit from $750 to $1,000 per state fiscal year; clarifies and updates the language for the allowable dental services for eligible adult beneficiaries; clarifies providers qualified to be reimbursed for delivery dental services; defines limitations and articulates reimbursement methodology for the allowable medical and surgical services for which a dentist may be reimbursed when delivered to eligible Medicaid beneficiaries.
