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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 proposed amendment updates the fee schedules for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies and Hearing Aids and Audiometric Evaluations.
Summary: The proposed amendment updates the Medication Assisted Treatment (MAT) fee schedules and provides a new direct reference to the Physicians and Other Practitioners page. The requested effective date for the proposed amendment is September 1, 2022.
Summary: CMS is issuing a technical correction to the approval package for TX-22-0028. TX-22-0028 introduced Page 1 of Supplement 5 to attachment 4.19-B as a NEW page, however a previously approved SPA already added Page 1 of Supplement 5 to attachment 4.19-B. This technical correction will make the page added by TN 22-0028 Page 1-a.
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 adopt the third amendment to the Public Readiness and Emergency Preparedness (PREP) Act which covers the Advisory Committee on Immunization Practices (ACIP) recommended vaccines for children ages three through 18 and indicate the state provides coverage of any drug or biological that is approved (or licensed) by the U.S. Food & Drug Administration (FDA)
or authorized by the FDA under an Emergency Use Authorization (EUA) to treat or prevent COVID-19, consistent with the applicable authorizations.
Summary: The SPA increases the nonemergency services’ limit to $2,000 per fiscal year to align with the administrative rule change and clarifies the prior authorizations requirements to align with current practice.
