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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: Effective July 1, 2021, this amendment establishes an ambulance transportation quality assurance fee program that will provide an add-on to fee-for-service emergency ambulance rates for non-public and non-federal emergency ambulance transportation providers. The add-on rate will be funded solely from assessments to the same providers. This assessment and add-on rate will not apply to any unit of government as defined in 42 CFR Sec 13 433.50, including federally recognized Indian tribes.
Summary: Effective February 20, 2021, this amendment is to amend the provisions governing laboratory and radiology services in order to ensure that the existing language reflects current practices, remove coding and billing instructions and other extraneous information.
Summary: Effective February 24, 2021, this amendment adds payment for tribal health clinics including an alternate payment method for tribal Federally Qualified Health Center (FQHCs) equal to OMB all-inclusive rate.
Summary: Effective November 1, 2020, this amendment implements a nursing facility supplemental payment for full restoration of the alternative methods of cost containment associated with the across the board two percent annual uniform reduction of Medicaid payments.
Summary: Effective May 1, 2021, this amendment updates the methods and standards for setting personal care rates for both agency and consumer directed services.
Summary: Effective January 1, 2021, this amendment adopts a new resource disregard under the authority of section 1902(r)(2) of the Social Security Act. The agency chooses to provide a reasonable timeframe for reducing excess resources accumulated during the COVID-19 public health emergency (PHE) by certain individuals subject to the post-eligibility treatment of income (PETI) rules for long-term services and supports (LTSS). Under FFCRA, these individuals accumulated extra resources, due to no changes being made to their PETI. Income they would have otherwise paid toward the cost of their care resulted in an increase in their resources that began to exceed program standards. This methodology also will prevent an institutionalized beneficiary from having to spend down any such excess resources during the PHE. This methodology will remain in effect through the twelve months following the end of the COVID-19 PHE.
Summary: Effective April 1, 2021, this amendment updated the fee schedule effective dates for several Medicaid programs and services. This is a regular, budget neutral update.
Summary: Effective January 1, 2021, this plan amendment updated the methods and standards used by Massachusetts to set payment rates for SUD clinic services.
