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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 proposes to extend the current exemption to the Recovery Audit Contractors (RACs) requirements to have a vendor that identifies and corrects improper Medicaid payments through the collection of overpayments and reimbursement of underpayments from August 5, 2022, to August 4, 2024.
Summary: This amendment proposes to extend the current exemption to the Recovery Audit Contractors (RACs) requirements to have a vendor that identifies and corrects improper Medicaid payments through the collection of overpayments and reimbursement of underpayments from August 5, 2022, to August 4, 2024.
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 rescind the Disaster Relief provision to expand medication prior authorizations to allow renewal automatically without clinical review or time/quantity extensions.
Summary: The amendment seeks to update Rhode Island’s Medicaid State Plan to provide assurance of coverage of COVID-19 vaccine administration, testing, treatment, and stand-alone vaccine counseling for children.
Summary: This amendment is to temporarily increase rates of payment for Assertive Community Treatment (ACT) services as a component of Rhode Island’s 9817 plan implementation.
Summary: This amendment is to temporarily increase rates of payment for Assertive Community Treatment (ACT) services as a component of Rhode Island’s 9817 plan implementation.
