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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 establish coverage of COVID-19 vaccine administration and a reimbursement rate for COVID-19 vaccine administration.
Summary: This amendment was submitted in order to clarify the existing clinic services benefit and to add a $1,000 per calendar year dental benefit for adults.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. This state plan amendment provides coverage of the administration of COVID-19 vaccines upon Emergency Use Authorization or approval from the Food and Drug Administration. This state plan amendment also increases reimbursement for COVID-19 vaccine administration based on the Medicare prevailing rate.
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 increase payment rates for durable medical equipment, dental services, ambulance services, physical therapy, occupational therapy, speech therapy, intermediate care facilities, and personal care services. The payment increases are effective from July 1, 2020 through December 31, 2020.
Summary: Effective 02/01/2021 for a two-year period only, with a termination date of 01/31/2023,this amendment provides an exception to the Medicaid Recovery Audit Contractor program.
Summary: This SPA allows a bundled payment methodology for rehabilitative mental health services when provided in crisis receiving centers. It also clarifies the purpose of rehabilitative mental health services including psychiatric diagnostic evaluation as for the direct benefit of the beneficiary.
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 begin reimbursing enrolled Hospitals and Critical Access Hospitals for the use of Medicare certified swing beds and to adjust certain inpatient rates to allow for increased reimbursements.
Summary: update the definition of a chiropractor in the state plan and to allow for up to 20 combined visits of physical therapy, occupational therapy, and chiropractic services without a referral or prior authorization.
