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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: With this amendment, the state will 1.) update conflict of interest (COI) standards to define provider shortage areas; 2.) clarify COI safeguards; 3.) update provider qualifications for Care Coordinators by clarifying providers must be at least 18 years old; 4.) update the quality improvement strategy; and 5.) update the non-medical transportation unit of service.
Summary: With this amendment, the state is updating the professional qualified to submit a statement of need for services. CMS supports approval of this amendment as it will not have a negative beneficiary impact, is consistent with Medicaid statutory requirements, regulations, and policies and permits the state to make systemic changes to allow them to administer the program as they desire.
Summary: The State expands 1915i eligibility by accepting the attestation of an individual assessment of need, which the State Evaluation Team uses to determine am individual’s eligibility for this benefit, from additional licensed providers.
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 rescinds temporary disaster relief provisions of the state plan to allow the agency to make American Rescue Plan Act Section 9817 increases for home and community-based services by Provider Types 29, 30, 39 and 83.
Summary: The 1915(i) Behavioral Health state plan amendment (SPA), which runs concurrently with an 1115 Behavioral Health demonstration for managed care, will be extended for one year. The 1915(i) serves individuals with serious emotional disturbances and intellectual and developmental disabilities.
Summary: California Disaster Relief (DR) SPA 22-0038 will temporarily implement the addition of Self-Directed Support Services and Technology Services and temporarily implement increases to incentive payments for Prevocational and Supported Employment Services. This SPA is effective July 1, 2021 through the end of the COVID-19 Public Health Emergency (PHE).
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 10% rate increase for providers of Title XIX Home and Community Based Services as follows: (HCB) Personal Care Services, 1915(k) Community First Choice Services (CFC), and Long-Term Services and Supports Targeted Case Management Services(LTSS-TCM). The department intends this increase to facilitate increased wages and promote the hiring and retention of HCBS direct service workers, an area adversely impacted by the COVID-19 pandemic.
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 establish a direct wage floor and workforce retention bonus payments to long-term personal care providers, in accordance with the State's approved Home and Community Based Services spending plan authorized under Section 9817 of the American Rescue Plan Act.
