An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: To update the State Plan language to comply with the amended section 1905(a)(30) of the Social Security Act, assuring coverage to eligible Medicaid participants for routine patient costs for otherwise covered items and services resulting from a qualifying clinical trial.
Summary: To update the State Plan language regarding the guidance on in-patient delivery hospital stays, clarifying the authorization requirements for both vaginal and cesarean deliveries.
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 permit the District of Columbia Medicaid Program to increase reimbursement to Medicaid providers to one hundred percent (100%) of the rates paid by the Medicare program in order to support additional costs related to administration of COVID-19 vaccines during the COVID-19 public health emergency effective December 11, 2020. The SPA will also clarify that COVID-19 vaccine administration may be reimbursed to the administering provider, but not the nursing facility or intermediate care facility for individuals with intellectual disabilities (ICF/IID), where the procedure is provided to a Medicaid enrolled individual. Additionally, this SPA makes the following adjustments to benefits currently covered in the state plan: Coverage of COVID 19 vaccine administration may be furnished by pharmacies, pharmacists, pharmacy interns and pharmacy technicians within their scope of practice, who are qualified providers of COVID-19 vaccines in accordance with the PREP Act Declaration and authorizations.
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 delay rebasing of FQHC rates to January 1, 2022 and every three (3) years thereafter.
Summary: This amendment provides assurances to comply with federal non-emergency medical transportation requirements, as directed by CMCS in July 12, 2021, CMCS Information Bulletin.
