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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 implements coverage of the new mandatory benefits of COVID-19 Vaccines and Administration of the Vaccines, Diagnostic and Screening Tests, and Treatment, Specialized Equipment and Therapies, and Preventive Therapies by the requirements of Section 9811 of the American Rescue Plan (ARP) 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 any signature requirements for the dispensing of drugs during the public health emergency (PHE) from March 13, 2020 through June 30, 2021.
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 correct the payment amount approved in SPA 21-0029 of $1000 to Agency Directed personal care providers and Consumer Directed Attendants who provided personal care, attendant care, respite care, or companion care services to members who receive services via EPSDT during the first quarter of state fiscal year 2022.
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 provide a one-time $1,000 payment to personal care providers who provided services to members who receive services via EPSDT during the first quarter of state fiscal year 2022. The SPA also provides a temporary 12.5% rate increase for personal care, respite, and companion services provided via EPSDT from July 1, 2021 through December 31, 2021. Additionally, the SPA provides a temporary 12.5% rate increase for behavioral health, early intervention, private duty nursing (under EPSDT), addiction and recovery treatment services (ARTS), targeted case management, and home health from July 1, 2021 through June 30, 2022. The temporary 12.5% rate increases will not be subject to the state's 'lesser of' methodology to reimburse the lower amount of the amount billed or the state fee.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to authorize pharmacies, pharmacists, pharmacy interns, and pharmacy techs to administer the COVID vaccination under the preventive services benefit. The SPA also updates the reimbursement methodology for vaccine administration.
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 coverage of Remdesivir and Convalescent Plasma therapy treatment for hospitalized patients with confirmed or suspected COVID-19.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to disregard unemployment compensation benefits funded by the territory for the non-MAGI population
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to consider individuals who are evacuated or absent from the state due to the disaster or public health emergency and who intend to return to the state, to continue to be residents of the state. The amendment makes adjustments to the day supply and quantity limit for covered outpatient medications and will make exceptions to their published Preferred Drug List if drug shortages occur. In addition, the amendment increases payment rates for nursing facilities, specialized care providers, and updates the dental fee schedule.
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 cover the new optional group for COVID testing, impose less restrictive resource tests on certain eligibility groups, and to continue to consider residents who leave the Territory due to the disaster residents of the Territory.
