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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 to include coverage and reimbursement for the administration of monoclonal antibody treatment or any drug treatment authorized under an FDA Emergency Use Authorization for COVID-19.
Summary: This amendment proposes to permit the District to enroll additional licensed providers (psychologists, licensed independent clinical social workers, licensed professional counselors and licensed marriage and family therapists) to service the District’s Behavioral Health population.
Summary: This SPA proposes to expand the full continuum of substance use disorder care by increasing access to certain services to beneficiaries diagnosed with a substance use disorder.
Summary: Enables the state to change from using a prior Authorization method to using a Pre-Payment Review process for the Physical Therapy, Occupational Therapy and Speech Therapy programs.
Summary: Effective July 1, 2021, this amendment implements an Indian Managed Care Entity that will provide case management services on behalf of American Indian and Alaska Native (AI/AN) Oregon Health Plan members.
Summary: Effective October 1, 2020, this amendment permits the District of Columbia to provide medication-assisted treatment (MAT) for opioids use disorder (OUD) as a mandatory state plan benefit in compliance with section 1006(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). The SPA assures that the District covers as a mandatory benefit all FDA approved MAT drugs, FDA licensed MAT biological products, and MAT behavioral counseling and therapy services.
Summary: Moves Oregon’s current Medication Assisted Treatment (MAT) benefit from the optional benefit section in Oregon’s state plan to the required benefit section to comply with Section 1006(b) of the SUPPORT Act.
Summary: Effective April 1, 2021, this amendment permits the District of Columbia Medicaid Program to cover transplantation of a kidney or liver from a living donor and related care provided to that living donor.
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 Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) with a direct support professional (DSP) supplemental payment for the January 1, 2021 to March 31, 2021 period.
