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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 SPA proposes to change the service limits for comprehensive tobacco cessation services provided to pregnant women, including both counseling and pharmacotherapy, without cost sharing.
Summary: Proposes to Change the Claiming for Medicaid Transportation and Other Related Travel Costs from Admin to MAP and to Cover Transportation to Puerto Rico to Access Services Necessary to Diagnose Breast and Cervical Cancer when Provided on or After the Date of Eligibility.
Summary: The USVI proposes that effective January 1, 2014 it will pay Medicaid enrolled physicians for inpatient and outpatient procedures performed in an inpatient setting for Medicaid eligible patients at 1 00% of the current Medicare rates.
Summary: This Amendment proposed changes in pharmacy coverage required by Section 175 of the Medicare Improement for Patients and Oroviders Act of 2008 which amended section 1860D-2 (e) 2 (A) of the Act in include barbiturates" used in the treatment of epilepsy, cancer, or chronic mental health disorder" and benzodiazepines in Part D drug coverage.
Summary: Denies additional Medicaid Payments for cost incurred for potentially preventable conditions in the inpatient hospital setting and in non-institutional settings.
Summary: Implement an Express Lane eligibility determination for children who qualify under the new categorical group identified in SPA-13-002 based on the income eligibility determination in the SNAP program.
