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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 plan amendment is in response to the State Health Official (SHO) Letter #23-001 “Coverage and Payment of Interprofessional Consultation in Medicaid and the Children’s Health Insurance Program” issued January 5, 2023. In accordance with the SHO, the Department is updating its State Plan to reflect the date that interprofessional consultation services were added to the MA Program Fee Schedule.
Summary: This plan amendment updates the Alternative payment methodology to increase funding for FQHCs located in/operated by cities of the first class.
Summary: To update reimbursement methodology for Rehabilitation Day Services and Psychosocial Rehabilitation (Clubhouse) Services. To add screening, as a new service under the Mental Health Rehabilitative Services benefit. To rename Community Based Intervention Level 1, Multisystemic Therapy. To add a new service, Attachment and Biobehavioral Catchup, as a preventive service. To update the structure of Methadone Services in Opioid Treatment Programs.
Summary: The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed Illinois state plan amendment (SPA) to Attachment 4.19-D IL-23-0027, which proposes increases to the reimbursement rate for facilities by the Department of Public Health under the ID/DD Community Care Act as an ID/IDD facility and medically complex for the developmentally disabled facilities licensed under the MC/DD Act.
Summary: The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed Illinois state plan amendment (SPA) to Attachment 4.19-D IL-23-0033, which proposes to increase by 12% the support component of the nursing facility rate for facilities licensed under the Nursing Home Care Act as skilled or intermediate care facilities.
