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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: 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.
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.
Summary: Effective January 01, 2021, this amendment updates the optional state supplement program's annual income standards consistent with the federal register.
Summary: Updates the plan to expand coverage and reimbursement for vaccine administration in accordance with authorizations provided under the Public Readiness and Emergency Preparedness (PREP) Act declaration. Further, it clarifies the reimbursement methodology for medically necessary vaccines products; expands the list of practitioners able to order Home Health services; clarifies the administrative vaccine rate for children eligible under the Vaccine for Children (VFC) Program; and, incorporates reimbursement for administration of vaccinations to the adult population.
