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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 State Plan language regarding the Community First Choice program to permit remote reassessments under certain circumstances.
Summary: This amendment makes changes to provider qualifications for Child and Family Psychoeducation, Early Intensive Developmental and Behavioral Intervention (EIDBI), Mental Health Services, and Adult Rehabilitative Mental Health Services (ARMHS).
Summary: To establish Certified Community Behavioral Health Clinics (CCBHCs) in West Virginia. CCBHCs offer a package of behavioral health and substance use disorder (SUD) se1vices and support.
Summary: This amendment is to conduct Medicaid presumptive eligibility (PE) determinations. PE groups: children under age 19, parents and other caretaker relatives, pregnant women, adults, and former foster care children, the effective date is May 12, 2023. PE for individuals needing treatment for breast or cervical cancer, the effective date is January 1, 2023.
Summary: This ABP updates the coverage limit for diagnostic, preventative, and restorative dental services for adults aged 21 and older, excluding cosmetic services. It also aligns non-EHB adult dental coverage with changes approved in WV-24-0002.
Summary: This amendment allows licensed outpatient hospitals, with Center for Medicare and Medicaid approved hospital accreditation, to apply to become adult day treatment providers.
Summary: This amendment proposes to update the coverage limit for dental services for adults aged 21 and older for diagnostic, preventative, and restorative services, excluding cosmetic services.
Summary: This amendment expands the Officer-involved Community Care Coordination benefit to include additional providers, specifically those employed by Indian health service facility or facility owned and operated by a Tribe or a Tribal organization operating under Public Law 93-638 as a 638 facility.
