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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the updates to the definition of a visit to include telehealth services in Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal Health programs and rescinds the addition of associate marriage and family therapist (AMFT) and associate clinic social workers (ASW) in FQHCs and RHCs that were originally approved under CA Disaster Relief SPA 20-0024 on May 12, 2020.
Summary: The SPA uses American Rescue Plan Act (ARPA) reinvestment funds to establish peer recovery support services in SUD setting in alignment with behavioral health priorities and stakeholder response. This SPA also removed the waiver requirement for prescribing buprenorphine for opioid use disorder based on the federal Drug Enforcement Agency (DEA) Announcement.
Summary: This SPA is adding mandatory benefits regarding coverage of COVID-19 vaccines, testing, and treatments to the Medicaid State Plan. The state submitted the completed ARP preprints for COVID Vaccines, Testing, and Treatment.
Summary: This amendment proposes a change to the prior authorization requirements for non-routine therapy services provided to beneficiaries residing in nursing facilities.
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 extend the COVID-19 Emergency Sick Leave Benefits for In Home Supportive Services (IHSS) providers through December 31, 2022.
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 rescind the flexibility to deliver PCS not in accordance with the service plan.