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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 seeks to confirm that the state covers all preventive services assigned a grade of A or B by the U.S. Preventive Services Task Force (USPSTF), and all approved adult vaccines and their administration recommended by the Advisory Committee on Immunization Practices (ACIP), without any cost-sharing in order to demonstrate compliance with Section 4106 of the Affordable Care Act.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment to 1) allow Hospital Presumptive Eligibility (HPE) for individuals aged 65 and over who have income under 100% of the Federal Poverty Level, 2) eliminate copays for acute inpatient hospital stays for all members, and 3) eliminate cost sharing for all COVID-19 testing and treatment services.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to waive cost-sharing for testing services, testing-related services and treatments of COVID-19 and suspend the face-to-face requirements for community mental health centers.
Summary: This amendment complies with Section 1 15 of the Medicare Improvements for Patients and Providers Act of 2008, which requires States to exempt Medicare cost-sharing benefits paid under the Medicare Savings Programs (MSPs) from estate recovery under section 191 7(b)(l) of the Act.
