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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 amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15. Vermont is also updating the converted MMDL language in the Health Homes SPA to include the assurance in accordance with federally mandated quality reporting for the Health Home Core Set as outlined with requirements in 42 CFR §§ 437.10 through 437.15 .
Summary: Effective January 1, 2021, this amendment expands the provider types that can authorize home health plans of care and order durable medical equipment.
Summary: The purpose of this SPA is to increase the Medicaid rates for Assisted Living Facilities, Adult Family Homes, Adult Day Health, Agency Providers, Independent Providers, Nursing Facilities, and Nursing Facility Swing Beds.
Summary: Implemented a 20 percent rate increase across all three tiers of Health Home services and reduced the performance incentive payment to 5 percent.
Summary: Revision for the adult day health services provided to individuals with physical and cognitive impairments who do not meet a nursing home level of care.
