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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: The purpose of this SPA to implement mandatory coverage and reimbursement of COVID-19 testing, vaccine and vaccine administration, and treatment in accordance with Section 9811 of the American Rescue Plan (ARP) Act.
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 any signature for the dispensing of drugs during the Public Health Emergency through May 1, 2022.
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 update nursing home rate components for general liability, property insurance, and property tax pass-through to the 2021 cost report.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to increase the reimbursement rates for the COVID-19 Vaccine to 100 percent of the Medicare reimbursement rate ($40.00 per dose) beginning April 1, 2021 through the end of the Public Health Emergency.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to increase nursing home per diem to cover increase in cost due to public health emergency for the period 7/1/2020 – 6/30/2021.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide flexibilities for presumptive eligibility, suspend all copayments, allow telehealth and provide an associated payment methodology, allow brand name products if generic prescription drugs are unavailable from the preferred drug list, and make interim payments to skilled nursing facilities.
Summary: Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT)
Summary: Proposes to make Graduate Medical Education (GME) paid claims Add-On Payments for Community Service Boards (CSBs) with GME programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME).
