An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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 SPA clearly defines the comprehensiveness issues regarding the reimbursement methodology for the State operated dental school, University of North Carolina School Of Dentistry.
Summary: The state plan proposes revisions to the reimbursement methodology for physician administered contraceptives at Wholesale Acquisition Cost (WAC) plus 6% and physician administered vaccines (as noted on the medical pages) at WAC plus 3%, while all other physician administered drugs will remain at prices established on January 1, 2015.
Summary: The companion letter requested the state to clearly define and describe rehabilitation services and to identify the requirements for practitioner providers.
Summary: This amendment makes two changes to conform with the District's recently approved 1915(c) Home and Community- Based Services Waiver for the Elderly and Persons with Physical Disabilities (EPD Waiver). First, the SPA proposes to add safety monitoring related to activities of daily living to the list of allowable tasks for personal care aides. Second, the SPA proposes to align reassessment requirements for beneficiaries receiving personal care aide services under the State Plan with requirements for beneficiaries receiving personal care aide services under the EPD Waiver.
Summary: This SPA revised the Estate Recovery section to ensure the SPA is in line with the North Carolina Administrative Code and the Medicaid Manual.
Summary: Implements changes to the pharmacy reimbursement methodology for ingredient costs and the professional dispensing fees for clotting factor based on a survey of costs for Hemophilia Treatment Centers (HTCs) and non-HTCs.
Summary: This amendment will bring the District of Columbia into compliance with the reimbursement requirements of the Covered Outpatient Drug final rule with comment period (CMS-2345-FC) (81 FR 5170). Specifically, the District of Columbia proposes shifting from Estimated Acquisition Cost (EAC) to Actual Acquisition Cost (AAC) by using the National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee of $11.15. In addition, the SPA addresses coverage policies of covered outpatient drugs.
Summary: This amendment originally proposed to remove the October 31, 2011 end of service date and thereby allow Child Development Services Agencies to continue to be reimbursed and cost settled for providing this service.
Summary: Clarifies the scope of services available for individuals eligible for State Plan PCA services, under the SPA recently approved by CMS, SPA #15-007.
