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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: To include coverage for peer recovery support services within the state’s Other Diagnostic, Screening, Preventive and Rehabilitative Services benefit and the Mandatory Medication-Assisted Treatment (MAT) benefit. Individual peer support services will be reimbursed at a rate of $16.38 per 15-minute unit, and group peer support services will be reimbursed at a rate of $4.55 per 15-minute unit. This SPA also removes the DATA 2000 waiver requirement for the prescribing of buprenorphone for opioid use disorder.
Summary: 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: To reimburse for community violence prevention services. Coverage will be extending to this service at a fee-for-service rate of $32.76 per 30-minute increments up to a maximum of 100 increments in a rolling 12-month period.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to authorize temporary extensions of increases to the personal needs allowance for certain beneficiaries, a delay in rebasing rates for federally qualified health centers and specialty hospitals, reimbursement rate increases for certain facilities and services, and modifications to the District’s health home program.
Summary: This plan amendment will allow treatment in place and mobile integrated health services to be provided by emergency services transporters under the supervision of a physician. Treatment in place will reimburse at a rate of $150 and mobile integrated health services will reimburse at a rate of $150 per event.
Summary: 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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to modify the re-evaluation process for participants in the District's 1915(i) Housing Supportive Services program and allow for supplemental payments to direct care workers under section 9817 of the American Rescue Plan Act.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend 1915(i) Housing Support Services, direct support worker supplemental payments, and 1915(i) Adult Day Health Program flexibilities.
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 update housing supportive services provider qualification criteria, provide reimbursement for retroactive provider rate changes, to increase the personal needs allowance, and to waiver pharmacy signature requirements.
