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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 provides the United States Virgin Islands with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This amendment attests to the state’s coverage of COVID-19 vaccines and vaccine administration, COVID-19 testing, and COVID-19 treatment, as required by sections 1905(a)(4)(E) and 1905(a)(4)(F) of the Social Security Act (Act).
Summary: This SPA provides West Virginia with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This amendment assures the American Rescue Plan Act’s (ARP) mandatory coverage of the COVID-19 vaccine, testing, and treatment without cost sharing.
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 expand telehealth, allow 90-day refills and expand prior authorization for medications, nursing home rate increase, reimbursements to certain providers for COVID-19 related expenses; increase therapeutic leave for individuals with IID/IDD living in ICFs, and waive automatic discharge from ICF after 30 hospital stay days.
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 providers and specify provider qualifications (training and supervision requirements) as well as, to clarify 15 minute increment payment policy.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, raise resource standards for the ABD population, expand presumptive eligibility, add Personal Care Attendant Services, add telemedicine services, and add reimbursement methodologies for the added services.
Summary: Technical changes to the Child Mental Health Wraparound HCBS state plan benefit to correct errors in pagination resulting from the approved SPA TN 19-007. This SPA makes revisions to the qualification requirements for staff making level of need determinations to allow for the inclusion of experience in areas closely related to wraparound services to count towards an individual’s experience, in addition to clinical experience.
