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Medicaid State Plan Amendments
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 SPA proposes to update the reimbursement methodology for physician administered drugs (PAD) to include the Nevada Medicaid’s PAD fee schedule.
Summary: This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.
Summary: This SPA adds the newly expanded adult eligibility group as an included population and implements per member per month payments for eligible Indian Health Services (IHS), Tribal 638, Urban Indian Health, and Federally Qualified Health Centers/Rural Health Clinic (FQHC/RHC) facilities.
Summary: The state adopts the the eligibility group serving individuals under age 65 with incomes at or below 133% of the federal poverty level (FPL), as described in section 1902(a)(10)(A)(VIII) of the Social Security Act.
Summary: This SPA was submitted to add an Alternative Benefit Plan (ABP) to South Dakota’s state plan to cover the Medicaid Expansion
Population, effective July 1, 2023.
Summary: This amendment is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.
Summary: This SPA proposes to update the excluded drug coverage language, as well clarify that for claims billed through the pharmacy point of sale system will be reimbursed using the reimbursement methodology found in Attachment 4.19-B for prescribed drugs.
Summary: This SPA is to amend the provisions governing behavioral health rehabilitation services in order to remove the face-to-face requirement for Community Psychiatrics Support and Treatment (CPST) and to add permanent supportive housing agencies to the provider qualifications for Peer Support Services (PSS).
Summary: This amendment proposed to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This SPA amendment is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.
