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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: Establishes a new level of reimbursement for Medicaid-eligible individuals who have severe behavioral needs residing in or seeking admission to Intermediate Care Facilities for Individuals with Developmental Disabilities (ICFs/IID), updates buy-back provisions for ICFs as authorized in the State’s Fiscal Year 2021-22 General Appropriations Act, and makes technical / editorial changes.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to add an Intensive Outpatient rehabilitation benefit for youth with serious emotional disturbance (SED).
Summary: This plan amendment was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for medication assisted treatment services the same as those in effect April 1, 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021.
Summary: Allows the Alabama Medicaid Agency to apply the reimbursement basis for inpatient and outpatient hospital services for State fiscal year 2022 (Medicare and cost, respectively) used in fiscal year 2021 including an adjustment to utilization trends impacted by COVID-19.
Summary: This amendment continues reimbursement authority for New Jersey's Charity Care Subsidy Disproportionate Share Hospital (DSH) program in the amount of $319,000,000.
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 expand telehealth, allow 90-day refills and expand prior authorization for medications, nursing home rate increase, reimbursements to certain providers for COVID-19 related expenses; increase therapeutic leave for individuals with IID/IDD living in ICFs, and waive automatic discharge from ICF after 30 hospital stay days.
