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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 state plan amendment updates the description of Florida Agency for Health Care Administration (AHCA) procedures for audits of Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), specifying that audits shall be based on American Institute of Certified Public Accountants (AICPA) Attestation Standards for examining or reviewing statistical information and data.
Summary: To amend the coverage of lactation counseling services for pregnant and post-partum women by expanding the list of those able to provide lactation services in accordance with Social Services Law 365-a(x)(i).
Summary: Allows the Current Dental Terminology (CDT) dental codes to be updated from the CDT 2021 (“CDT-21”) code set to the CDT 2022 (“CDT-22”) code set for the purpose of dental service reimbursement.
Summary: Increases medical assistance rates of payment for diagnostic and treatment center services to New York City Health and Hospitals Corporation and county operated DTCs and mental hygiene clinics.
Summary: Sets a new rate exception for Southern Maine Health Care, updates the supplemental payment pool for inpatient hospital services, and updates a supplemental payment pool for certain other hospital classes.
Summary: to add a Recovery Audit Contractor (RAC) and requests that CMS use its regulatory authority under 42 CFR §455.516 to grant the following three exceptions to the Medicaid RAC contracting requirements:
Allow the RAC to use a panel of physicians to perform the activities of the medical director required by 42 CFR §455.508(b);
Allow the RAC to review claims that are up to five years old, rather than the three-year limit described in 42 CFR §455.508(f); and
Allow the contingency fee paid to the RAC to exceed that of the highest Medicare RAC, and allow federal financial participation (FFP) for the full amount of the contingency fee paid to the RAC, waiving requirements of 42 CFR §455.510(b)(4)
Summary: To add pharmacy interns to Other Practitioner Services, under section Pharmacists and Pharmacy Interns as Immunizers. Also, this SPA proposes to reimburse for Diabetes Self-Management Training (DSMT) services for persons diagnosed with diabetes when such services are ordered by a physician, registered physician assistant, registered nurse practitioner, or licensed midwife and provided by a licensed, registered, or certified health care professional.
Summary: To incorporate additions to the benefits and payment state plan pages in order to implement the Center for Medicare & Medicaid Innovation's (CMMI) Integrated Care for Kids (InCK) ModeL a child-centered local service delivery and state payment model The state will limit implementation of the InCK Model to two counties in the state utilizing CMMI waiver authority in section 1115A(d)(1) of the Social Security Act. The CMMI waiver authority is applicable only while the New Jersey InCK Model is implemented in accordance with the InCK Model's Terms and Conditions of Award.
Summary: This amendment proposes to add services to the Newborn Nurse Home visiting program, including maternal and newborn physical assessment; anticipatory and supportive guidance.
