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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 describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.
Summary: The state adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: The SPA clarifies how the premium assistance program determines if premium assistance is estimated to be cost effective and aligns with policies and current practice.
Summary: This amendment ensure that the agency's cost-sharing authority reflects co-payments that are currently in practice. This request also seeks to remove cost sharing for vaccine administration per the Inflation Reduction Act provision prohibiting cost sharing for Advisory Committee on Immunization Practices (ACIP) recommended vaccines for adults.
Summary: This SPA provides Oklahoma with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This SPA expanded eligibility in the former foster care children (FFCC) eligibility group consistent with the changes mandated by Section 1002 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (Support) Act.
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 waive signature requirement for pharmacy counseling and to increase reimbursement rates for private duty nursing services.
Summary: The SPA increases the nonemergency services’ limit to $2,000 per fiscal year to align with the administrative rule change and clarifies the prior authorizations requirements to align with current practice.
