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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: This SPA allows coverage of medically necessary prescribed drugs that are not covered outpatient drugs, including drugs authorized for import by the U.S. Food and Drug Administration (FDA), during drug shortages. In addition, this SPA proposes to reimburse prescribed drugs that are not considered covered outpatient drugs utilizing the same methodologies as covered outpatient drugs.
Summary: Provides authority to amend the method for determining the current asset value bed limit for Class 1 nursing facilities by recognizing an upper limit based on a rolling 15-year history of new construction costs.
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 provide authority for an Alternative Payment Methodology to specific providers for COVID-19 vaccine administration.
Summary: Provides authority to allow Tribal 638 pharmacies to be reimbursed at the Indian Health Services outpatient all-inclusive rate (A.I.R.) per visit
Summary: This amendment proposes to add medication assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. This letter is to inform you that Michigan’s Medicaid SPA TN 21-0005 is approved effective October 1, 2020 until September 30, 2025, pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act.
