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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 proposes to change provider requirements for community mental health centers, adds coverage of prophylaxis under the state’s dental benefit, allows for 90-day coverage of maintenance medications, and adds weight loss drugs to the state’s prescription drug formulary.
Summary: To remove information related to a "Reasonable Eligibility Period" eligibility pilot that the state implemented from July 1, 2018, through June 30, 2019. SPA 21-0022 will remove the pilot information from the Medicaid State Plan.
Summary: CMS is approving the state’s request to amend its 1915(i) state plan home and community-based services (HCBS) benefit, transmittal number TN 21-00004.
Summary: Authorizes the department to establish provider specific rates for services provided by Psychiatric Residential Treatment Facilities (PRTFs). The amendment also removes outdated language
Summary: Makes changes to the 1915(k) Community First Choice state plan option to include changes related to Washington's response to the COVID-19 outbreak.
Summary: This SPA amends the Specialized Services section in the State Plan to note that specialized services delivered at the facility or those that take the resident into the community may be suspended due to a state or federal national emergency.
