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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: Memorialize changes made during the COVID-19 Public Health Emergency to the My Health GPS Health Home Program. Modifications to the My Health GPS Program include changes to staffing ratios, provider payment reimbursement methodologies, and administering the needs assessment portion of a beneficiary's level of care review.
Summary: This plan amendment will permit the District of Columbia Medicaid Program to continue to provide supplemental payments through March 31, 2025 to direct support professionals who are likely to be paid at or near the minimum/living wage for delivering the follow State Plan services: 1905(a) Home Health Agency – Personal Care Aides; Home Health Aides, 1915(i) Adult Day Health Providers – Personal Care Aides employed as Direct Care Support staff, 1915(i) Supported Employment Providers - Certified Peer Specialists.
Summary: This plan amendment updates Medicaid reimbursement rates for physical therapy, occupational therapy, and speech-language therapy services under the home health benefit.
Summary: The District is seeking to sustain requests approved in their Temporary Extension to the Medicaid Disaster Relief COVID-19 National Emergency SPA #23-0004, which expires on May 11, 2024, by adding its language to the permanent Housing Supportive Services (HSS) 1915(i) Home and Community-Based Services SPA. If approved, this SPA will permit the HSS program to continue to utilize the appropriate determination and redetermination tools to ensure that District residents secure and maintain permanent supportive housing and to allow expanded provider qualifications for case manager supervisors.
Summary: This amendment is to remove the Targeted Case Management program for clients with poorly controlled asthma or a history of environmentally induced respiratory distress from the state plan as the program ended on July 1, 2023.
Summary: This plan amendment is adding Inter-professional Consultation and Collaborative Care Services under the District’s physician services benefit.
