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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: Adds peer support and coordination services, which are provided to individuals after an opioid overdose, to the state’s Alternative Benefit Plan (ABP). These peer support and coordination services have been added to the benefit package in the Medicaid state
plan and this SPA would align the benefits of both benefit packages.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to cover hospital swing bed services in cases where a nursing home bed is not available.
Summary: This amendment proposes to add medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. This letter is to inform you that New Jersey’s Medicaid SPA Transmittal Number #21-0003 was approved on September 23, 2021 with an effective date of October 1, 2020, until September 30, 2025, pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act.
Summary: Effective October 1, 2018, this amendment adds coverage of long term residential substance use disorder services, which would allow an individual to initiate and receive services to treat substance use disorders in a less intense care setting, to the state's alternative benefit plan (ABP).
Summary: This amendment will be modifying Wisconsin's payment methodology to nursing homes for COVID-19 Vaccines which are administered by skilled nursing facilities.
Summary: Effective January 1, 2021, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. CMS notes that Wisconsin covered all required MAT services to treat Opioid Use Disorder (OUD) elsewhere in the state plan prior to the January 1, 2021 effective date of the SPA.