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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: update the benchmark plan for the ABP for the New Adult Group. This is being updated to a 2014 base benchmark plan pursuant to 45 CFR §156.110. The ABP delivery model summary is also being updated based on the approved 1115 Global Commitment to Health waiver. This SPA was approved June 10, 2021 with an effective date of January 1, 2017.
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: 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: This amendment proposes to add coverage for a new type of non-emergency medical transportation (NEMT) called Non-Emergency Secure Behavioral Health Transport as an optional medical service outside of the state's NEMT broker program to the state’s Alternative Benefit Plan pages.
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: We have reviewed the proposed amendment to Attachment 4.19-D of your Medicaid state plan submitted under transmittal number (TN) 20-0014. Effective September 1, 2020, this state plan amendment changes reimbursement for certain intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) to a cost reimbursement methodology.
Summary: This SPA permits licensed pharmacists to enroll in the Vermont Medicaid program, allowing coverage of COVID-19 diagnostic testing and specimen collection by licensed pharmacists to the extent permitted by state and federal law.
Summary: This SPA continues the authority for the Indigent Accident Fund program, a supplemental payment program based on inpatient hospital utilization to preserve access to inpatient hospital
