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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 amendment is to align the Alternative Benefit Plan with the Medicaid state plan by adding doula services and updates the Federally Qualified Health Centers (FQHC) and Rural Health Clinic (RHC) services category to include associate marriage and family therapist (AMFT) services and associate clinical social worker (ACSW) services.
Summary: This amendment proposes to align the Alternative Benefit Plan with the Medicaid state plan by adding asthma prevention services, community health worker services, and coverage of routine patient costs in clinical trials.
Summary: This amendment discontinues health homes from the Supports and Training for Employing People Successfully (STEPS) program alternative benefit plan.
Summary: Describes services for the adult expansion population, including home health, durable medical equipment, hospice, and non-emergency transportation services, to ensure that benefits for this population align with those for the rest of the adult population.
Summary: This ABP updates the coverage limit for diagnostic, preventative, and restorative dental services for adults aged 21 and older, excluding cosmetic services. It also aligns non-EHB adult dental coverage with changes approved in WV-24-0002.
Summary: This SPA provides assurance in Attachment D that the benefit package provided for all individuals through the postpartum extension complies with section 1937 of the Act, including the provision of essential health benefits (EHBs) and that no treatment limitations that are more restrictive than the Alternative Benefit Plan (ABP).
Summary: This amendment is being submitted to New Hampshire’s Alternative Benefit State Plan to demonstrate and ensure that community-based mobile crisis intervention services are provided to New Hampshire Medicaid beneficiaries as outlined in Section 9813 of the American Rescue Plan of 2021.
