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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 State Plan Amendment clarifies that Utah Medicaid will treat estranged spouses as individual households even when filing a joint tax return.
Summary: Grants authority to provide Opioid treatment Centers of Excellence services in the fee for servicer delivery system, aligning with similar services now available in managed care under recent health home State Plan revisions.
Summary: Revise's Utah pharmacy reimbursement methodology to comply with the key provisions of the Covered Outpatient Drug Final Rule with Comment( 81 FR 5170) that was published in the Federal Register on February 1, 2016.
Summary: This SPA grants authority to implement a rate decrease and methodology change for CEDAR services. This SPA also implements revised quality metrics and oversight.
Summary: This SPA grants authority to add CMHO Health Home services as an in-plan benefit for the Medicaid Managed care Organizations. The SPA further revises outcome measures and imposesa payment withhold.
Summary: This amendment elects for the State to use Utah' s single streamlined application form for both Medicaid and Presumptive Eligibility (PE) effective January 1, 2016.
