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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 (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow the state to reimburse administration fees for COVID-19 vaccinations at the same rate as Medicare.
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: This amendment clarifies that pharmacists are able to provide and bill for services according to their scope of practice by adding them to the list of "Other Licensed Practitioners."
Summary: Payments will be increased to one hundred fifty percent (150%) of the hospital’s fee-for-service rate for state and Federal medical assistance programs for services provided by qualifying hospitals.
Summary: Implements a resource disregard of earnings accumulated in a separate account during an individual's enrollment in a working disability eligibility group when determining the individual's subsequent eligibility for other eligibility groups covered under Washington’s state plan