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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: provide annual assurance of the pharmacy program adherence to the requirements of federal regulation for the time period October 1, 2019 through September 30, 2020.
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 the requirement for technicians delivering applied behavior analysis services to have the Registered Behavior Technician Credential due to testing center closure or delay related to COVID 19. They will continue to be required to operate under the supervision of a licensed behavior analyst or licensed psychologist.
Summary: Updates the provider fee schedule to add a modifier for individual, family, and group psychotherapy procedure codes to pay an enhanced rate for providers certified in specific evidence-based practices that provide evidence-based treatment to individuals under 21 years of age who have experienced severe physical, sexual, or emotional trauma as a result of abuse or neglect.
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 increase reimbursement to ASARS providers to support additional costs related delivery of services during the COVID-19 public health emergency effective March 1, 2020.
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 permit the District of Columbia Medicaid program to make retainer payments to Adult Day Health Program (ADHP) providers whose operations have been impacted by the ongoing public health crisis related to COVID-19.
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 provide case management services for the developmental disabled population via telephone for all four quarterly contacts in lieu of face-to-face contact for one of the quarterly contacts.
Summary: Allows a plan of care to be approved by a nurse practitioner, physician assistant or assistant physician and allows PDN services to be provided by a family member, parent, legally responsibly individual or legal guardian
Summary: Authorizes the District to enroll approximately 19,000 District individuals, who are currently assessing their benefits via fee-for-service, into Medicaid managed care
