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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: proposes to update the language pertaining to the admission review for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).
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 add vaccine administration for homebound beneficiaries under the preventive services benefit, including a brief health screening, in addition to administration of the COVID vaccine, and to add a reimbursement methodology to those services.
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: Effective October 1, 2020, this amendment adds the new mandatory MAT benefit 1905 (a)(29) in compliance with section 106(b) of the SUPPORT Act. MAT services include all FDA-approved or licensed drugs and biologicals to treat opioid use disorder (OUD), counseling services and behavioral therapy. These MAT services will provide necessary treatment for Medicaid beneficiaries with OUD and help address the national opioid epidemic.
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: 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.
