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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 amendment implements a performance standard for qualified entities and hospitals determining presumptive eligibility for the following Medicaid eligibility groups: Parent/Caretaker Relatives, Group VIII Adults, and Former Foster Care Children.
Summary: This amendment is to adopt the optional eligibility group described in section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act, which serves working individuals who have disabilities and incomes below 250 percent of the federal poverty level.
Summary: This amendment establishes coverage and payment provisions for preventive services provided by doulas and lactation consultants under the state plan.
Summary: Clarifies coverage of diabetes self-management training services as dieticians’ services and reflects a change in terminology from “lactation counseling services” to “lactation consultation services.”
Summary: Allows entities licensed by the Department of Behavioral Health and Developmental Services as providers of case management services, specifically community services boards, to provide services under the brain injury services targeted case management (BIS TCM) program.
Summary: This amendment is to amend its hospital presumptive eligibility SPA and presumptive eligibility program to include a performance standard for qualified entities or hospitals determining presumptive eligibility for pregnant women and/or children.
Summary: This amendment provides reimbursement for services provided by licensed pharmacists, and pharmacy interns and pharmacy technicians supervised by phamacists, who are acting within their scope of practice or in a collaborative agreement with a provider licensed in Virginia or are specified in Board of Pharmacy protocols for licensure that have been reviewed and accepted by the Department of Medical Assistance Services and are services covered by Medicaid.
