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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 adds home health and hospice services for adults and updates the language under the Other Licensed Practitioners benefit. Additionally, the state clarified that benefits for the medically needy are the same as those for the categorically needy.
Summary: This SPA provides Nevada with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
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 by the requirements of Section 9811 of the American Rescue Plan (ARP) Act.
Summary: This amendment proposes to assure the American Rescue Plan Act’s (ARP) mandatory coverage of the COVID-19 vaccine, testing, and treatment without cost sharing.
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 authorize pharmacies, pharmacists, pharmacy interns, and pharmacy techs to administer the COVID vaccination under the preventive services benefit. The SPA also updates the reimbursement methodology for vaccine administration.
Summary: Effective beginning October 1, 2020 and ending September 30, 2025, this amendment adds a Supplement 2 to Attachment 3.1-A for Medication-Assisted Treatment (MAT) as required within section 1905(a)(29) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act of 2018.
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 the Other Licensed Practitioners to include pharmacies, pharmacy interns, qualified pharmacy technicians, and licensed dental hygienists, and to allow for 100% Medicare payment for COVID-19 vaccine administration.
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 of Remdesivir and Convalescent Plasma therapy treatment for hospitalized patients with confirmed or suspected COVID-19.