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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: Adds an assurance that the Department of Medical Assistance Services will make coverage and billing code modifications when the Advisory Committee on Immunization Practices (ACIP) and/or U.S. Preventive Services Task Force (USPSTF) “A” and “B” recommendations change. The amendment also makes a technical change to revise reference to section “4016” of the Patient Protection and Affordable Care Act to section “4106.”
Summary: The state adopts 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: This SPA updates Illinois' Medicaid State Plan to comply with third party liability (TPL) requirements authorized under the Bipartisan Budget Act of 2018 and the Consolidated Appropriations Act of 2021.
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.
Summary: This SPA proposes to increase the professional dispensing fee for Illinois based hemophilia treatment centers for 340B purchased antihemophilic products to $207.
