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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 May 1, 2021, this amendment updates the methods and standards for setting personal care rates for both agency and consumer directed services.
Summary: Effective March 1, 2021, this amendment solicits advice from Tributes and Indian Health Programs, prior to submitting any plan amendments, waiver requests, and proposals for demonstration projects that are likely to have a direct effect on Indians, Indian Health Programs, or Urban Indian Organizations.
Summary: Effective October 1, 2020 until September 30, 2025, this amendment addresses the newly added mandatory benefit for coverage and reimbursement of medication-assisted treatment (MAT) in opioid treatment programs (OTPs) and office-based opioid treatment settings. The purpose of the SPA is to move Virginia’s current MAT benefit from the optional benefit section in Virginia’s state plan to the required benefit section to comply with Section 1006(b) of the SUPPORT Act.
Summary: Implements Mental Health Intensive Outpatient Programs, a new service for youth and adults; and Mental Health Partial Hospitalization Programs for Youth and Adults, which will replace the current Partial Hospitalization Program for adults
Summary: This amendment, effective October 1, 2020, authorizes the Arizona disproportionate share hospital (DSH) pool 1, 2, 1A, 2A and 4 payments, for the DSH state plan rate year ending 2021.
Summary: This amendment proposes to implement temporary policies, which are different from those policies and procedures otherwise applied under your Medicaid state plan, during the period of the Presidential and Secretarial emergency declarations related to the COVID-19 outbreak (or any renewals thereof).
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 identify an updated NEMT rate for drive-through vaccination sites, effective February 22, 2021.
Summary: Changes the eligibility section in the state plan to remove the requirement for 40 qualifying quarters of employment for lawful permanent residents.
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 permit a second COVID-19 related direct payment for nursing facilities that is identical to the first approved payment. The payment for each provider is computed at $30 multiplied by the number of Medicaid fee-for-service bed days during the proxy period of 10/1/19 to 12/31/19.