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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 implements coverage of the new mandatory benefits of COVID 19 Vaccines and Administration of the Vaccines, Diagnostic and Screening Tests, and Treatment, Specialized Equipment and Therapies, and Preventive Therapies in accordance with the requirements of Section 9811 of the American Rescue Plan (ARP) Act.
Summary: WA-22-0019 is submitted to comply with the American Rescue Plan (ARP) requirements for states to ensure access and coverage to COVID-19 Vaccine, Treatment, and, Testing.
Summary: This SPA provides Washington with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: Effective October 1, 2020 until September 30, 2025, pursuant to 1905(a)(29) of the Social Security Act and Section 1106(b) of the SUPPORT Act, this amendment adds the medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Summary: Effective January 27, 2021, this amendment brings the state into compliance with a court order that instructs the state to cover medically necessary Applied Behavior Analysis (ABA) therapy to treat Autism Spectrum Disorder (ASD) for Medicaid Managed Care Organization (MCO) clients over the age of twenty and removes the limitation for managed care and fee-for-service enrollees in the Applied Behavior Analysis (ABA) therapy to treat Autism Spectrum Disorder (ASD.)
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 termination date of some previously approved provisions, to end at an earlier date.
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 provide coverage for lab or x-ray services intended to diagnose or detect antibodies for COVID-19; increase certain payment rates; and extend resident absences from nursing facilities.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow cover the new optional group for COVID testing; apply less strict resource and income methods when determining eligibility for certain individuals; consider individuals evacuated from the state due to the emergency to continue to be residents; provide medical coverage to non-residents who are quarantined in the state due to COVID-19; allow hospitals to make presumptive eligibility decisions for certain individuals; suspend enrollment fees and premiums for all individuals; expand telehealth; add certain benefits and increase some payment rates related to the COVID-19 national emergency.
