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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: 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.
Summary: This SPA updated the fee schedule effective dates for several Medicaid programs and services. This is a regular, budget neutral update to keep rates and billing codes in alignment with the coding and coverage changes from the Centers for Medicare and Medicaid Services (CMS), the state, and other sources.
Summary: This amendment updates the requirements in the Medicaid State Plan for licensed mental health professionals who provide outpatient mental health services to clients eighteen years of age and younger.
Summary: This plan amendment authorizes the District of Columbia Medicaid Program to continue its authority beyond the public health emergency to permanently reimburse COVID-19 vaccines and COVID-19 vaccine administration at one hundred percent (100%) of the Medicare rates.
Summary: The purpose of this amendment is to comply with the requirements for mandatory coverage of COVID-19 vaccines, testing, and treatment without cost-sharing under section 9811 of the American Rescue Plan.
