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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 modifies the state’s paper and online applications to integrate eligibility for the state’s 1115 family planning demonstration waiver into the state’s Medicaid eligibility application and eligibility determination system. The changes are limited to inclusion of two additional questions to ensure an applicant can apply and be determined eligible for family planning coverage, as provided under Montana’s section 1115 family planning demonstration.
Summary: Effective May 1, 20201, this amendment replaces certified diabetes educator requirements with more pertinent training/experience for existing providers of diabetes self-management education and support services(DSMES). Additionally, the amendment adds licensed health care professionals who hold a board certification in advanced diabetes management are certified diabetes care and education specialists, or are under the supervision of a licensed practitioner within state scope of practice as a provider of DSMES services.
Summary: Effective February 1, 2021, this amends the current targeted case management state plan amendment for public health nurse home visiting to include three additional counties (Baker, Clatsop and Marion).
Summary: Effective December 27, 2020, this amendment continues an additional class of disproportionate share hospital payment to facilities meeting certain low-Income utilization rate (LIUR) and net patient revenue criteria while operating in a medically underserved area.
Summary: This amendment clarifies that pharmacists are able to provide and bill for services according to their scope of practice by adding them to the list of "Other Licensed Practitioners."
Summary: Effective 02/01/2021, this update amends the provisions governing adult mental health services in order to add peer support services as a covered rehabilitative service.
