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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: 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: Updates the state plan language referenced in the section, Other Licensed Providers. The SPA removes the reference to ophthalmologists, as these are physicians and are covered under the Physician Services section of the state plan, clarifies that optometrists and opticians are licensed providers and lists each type of other licensed provider that can enroll with the Virginia Department of Medical Assistance Services.
Summary: This SPA establishes a partial benefit package of family planning and family planning-related services to individuals whose income is at or below 208% of the federal poverty level.
Summary: To implement 12-months of continuous eligibility for children as required by the 2023 Consolidated Appropriations Act. This SPA also makes a technical change to note that the Virginia Department of Medical Assistance Services processes the eligibility applications of individuals who are returning to the community after a period of incarceration. Additionally, this SPA makes technical corrections to the "Eligibility Determinations and Fair Hearings" and "Organization and Administration" reviewable units approved in VA-23-0007 regarding Virginia's transition to a new State-Based Exchange.
Summary: This SPA will include transportation network companies as a type of non-emergency transportation provider that may be used to provide covered transportation services.
Summary: To increase the income standard for its Ticket to Work Basic eligibility group and disregard “Work Incentive Accounts” in determining resource eligibility for certain non-MAGI eligibility groups.
