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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: 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 provide a reimbursement methodology for Medicaid vaccine administration fees and pharmacy dispensing fees for the COVID-19 vaccine.
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 lock-in the calendar year (CY) 2020 School-Based Wellness Center (SBWC) Clinic Services per-visit rates for the entire CY 2021 and to maintain the rates for a first year nursing facility (NF), Polaris, through CY 2021, which are based on an estimated cost report they provide for a one-year period (CY 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 make an add-on per diem payment to a nursing facility that has a dedicated isolation unit for treatment of COVID (COVID Unit).
Summary: Effective January 01, 2021, this amendment removes an incorrect acronym used in describing the provider qualifications for the Individual Intensive Supports service. The change does not alter the provider qualifications themselves.
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 add pharmacy interns and techs to the providers who can administer vaccines. It also notes that the State will follow current vaccine administration reimbursement methodology for interns and techs, paying $14.15 per vaccine administration.
Summary: Effective March 1, 2021, this amendment updates the early and periodic screening, diagnostic, and treatment (EPSDT) fee schedule to add reimbursement rates for cranial remolding helmets.
Summary: The purpose of this amendment is to establish an Alternative Payment Methodology for tribal health facilities that agree to enroll as a Tribal Federally Qualified Health Center (Tribal FQHC).
