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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: The purpose of this amendment is to establish an Alternative Payment Methodology for tribal health facilities that agree to enroll as a Tribal Federally Qualified Health Center (Tribal FQHC).
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 implement a temporary rate increases of 2.3% for home health aide services provided by home health agencies, specifically HCPCS T1004, T1021 effective Sept 1 through October 31, 2020.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this SPA is to waive or modify certain requirements of Title XIX of the Act to address the COVID-19 public health emergency, in order to provide a one-time lump sum payment to privately owned and operated intermediate care facilities (ICF) for individuals with intellectual disabilities (IID), and a one-time lump sum payment for Long Term Personal Care Services providers.
Summary: The Louisiana Department of Health, Bureau of Health Services Financing proposes to amend the provisions governing the reimbursement methodology for nursing facilities in order to increase the allowable square footage for calculating payments when a Medicaid participating nursing facility has at least 15 percent of its licensed beds in private rooms
Summary: Updates the plan to expand coverage and reimbursement for vaccine administration in accordance with authorizations provided under the Public Readiness and Emergency Preparedness (PREP) Act declaration. Further, it clarifies the reimbursement methodology for medically necessary vaccines products; expands the list of practitioners able to order Home Health services; clarifies the administrative vaccine rate for children eligible under the Vaccine for Children (VFC) Program; and, incorporates reimbursement for administration of vaccinations to the adult population.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to update Payment Methodologies for Certain Hospital, Community Health Centers, Physician, and coverage for mobile testing service done by EMTs during the COVID-19 Emergency period.
Summary: Proposes to allow Physician Assistants to bill independently from the supervising physician. The SPA also establishes a rate payment for Physicians Assistants
Summary: Effective January 24, 2021, this amendment continues Pennsylvania's authority to continue Medical Assistance Day One Incentive (MDOI) payments to nonpublic nursing facilities and sets the funding levels for Fiscal Year 2021.
Summary: Effective December 16, 2018, this amendment brings Missouri into compliance with items contained in the reimbursement requirements for the Covered Outpatient Drug final rule with comment period (CMS-2345-FC) and includes: reimbursement rates for long-term care, specialty drugs, drugs purchased at a nominal price, and physician administered drugs and reimbursement methods that use, among others, the National Average Drug Acquisition Cost (NADAC) for covered outpatient drugs.
