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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: update the benchmark plan for the ABP for the New Adult Group. This is being updated to a 2014 base benchmark plan pursuant to 45 CFR §156.110. The ABP delivery model summary is also being updated based on the approved 1115 Global Commitment to Health waiver. This SPA was approved June 10, 2021 with an effective date of January 1, 2017.
Summary: Effective January 1, 2021, this amendment expands the provider types that can authorize home health plans of care and order durable medical equipment.
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: This SPA permits licensed pharmacists to enroll in the Vermont Medicaid program, allowing coverage of COVID-19 diagnostic testing and specimen collection by licensed pharmacists to the extent permitted by state and federal law.
Summary: VT submitted this SPA to update the ABP for the new adult group in order to ensure alignment with the full Medicaid State Plan by referencing the new state plan section (G1 – G3) that describes cost-sharing requirements for Medicaid beneficiaries
