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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 updates the existing language to reflect the California Department of Social Services' (CDSS) updated In-Home Supports Services (IHSS) policy to allow telehealth reassessments and to reflect CDSS IHSS Quality Assurance (QA) updated practices.
Summary: The purposed amendment will add the current process of implementing updated inpatient and outpatient hospital per diem rates published by the by Indian Health Services (IHS) in the Federal Register.
Summary: This SPA provides Alaska with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program and increases the income eligibility for pregnant individuals up to 225 percent of the FPL.
Summary: This SPA eliminates the sunset date for approved supplemental payments and Alternative Payment Methodologies (APMs) for trauma screenings and developmental screenings.
Summary: This Alternative Benefit Plan (ABP) amendment complies with Section 11405 of the Inflation Reduction Act (IRA) aligning the new mandatory coverage of Medicaid adult vaccinations and the administration of vaccines for the expansion population under ABP5 benefit, without cost-sharing.
Summary: This Medicaid State Plan amendment complies with Section 11405 of the Inflation Reduction Act (IRA) aligning the new mandatory coverage of Medicaid adult vaccinations and the administration of the vaccines without cost-sharing.
Summary: The addition of diagnosis-related groups and a new disproportionate share hospital (DSH) category; andRemoval of outdated language, grammar revisions, and updated organization structure.
Summary: This amendment, the state is expanding the needs-based criteria for children under five, adds Participant-Directed Services and related budget authority, and adds incentive payments to providers who assist individuals with obtaining competitive and integrated employment.
Summary: This SPA amends the State plan pages to reimburse providers based on a submitted invoice price for a drug’s ingredient cost when other pricing benchmarks are unavailable.
