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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 to respond to the COVID-19 national emergency. The purpose of this amendment is to waive signatures for dispensing of drugs during the public health emergency with exceptions of controlled schedule 2 (CII) prescriptions.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to Temporarily extend the suspension of member copays and premiums for six months following the end of the PHE.
Summary: This amendment amends Delaware State Plan to assure coverage of routine patient costs associated with participation in qualifying clinical trials.
Summary: Amends Delaware Title XIX State plan specifically to attest that the Delaware Medicaid Transportation program is in compliance with section 1902(a)(87) of the Social Security Act.
Summary: This SPA proposes to amend the reimbursement methodology for provider-administered drugs from the Average Sale Price (ASP) Drug Pricing File to the same methodology as other covered outpatient drugs, with the exception that no professional dispensing fee will be paid. This SPA also replaced the term Utah Estimated Acquisition Cost (UEAC) with Wholesale Acquisition Cost (WAC).
Summary: This SPA implements policies and procedures to coincide with the merger of the Utah Department of Health and the Utah Department or Human Services, effective July 1, 2022. The new name of single state agency is the Utah Department of Health and Human Services.
Summary: This amendment proposes to assure the American Rescue Plan Act’s (ARP) mandatory coverage of the COVID-19 vaccine, testing, and treatment without cost sharing.
Summary: To update Delaware State Plan to bring the state in compliance with the Third-Party Liability Requirements under the Bipartisan Budget Act (BBA) of 2018 and Medicaid Services Investment and Accountability Act (MSIAA) of 2019 practices.
