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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 adds Children Behavioral Interventionist (CBI) Service, which will provide children/youth with neuro developmental activities for individuals/families that are struggling with behavior and emotional management issues as established in a person-centered treatment plan.
Summary: Allows the Virginia Medicaid program to comply with the 21st Century Cures Act requirement to implement an Electronic Visit Verification System for Home Health Care Services.
Summary: This amendment adds coverage and reimbursement of pharmacists as providers, and to authorize pharmacy technicians and interns to administer vaccines.
Summary: The Brain Injury Rehabilitation Facility (BIRF) rate will be increased from $700 per day to $1,400 and include non-traumatic as well as traumatic brain injury.
Summary: This amendment allows payment of medical assistance services delivered to Medicaid-eligible students when such services qualify for reimbursement by the Virginia Medicaid program and may be provided by school divisions, regardless of whether the student receiving care has an individualized education program or whether the health care service is included in a student's individualized education program. In addition, the state included new transportation and personal care service language.
Summary: Removes the federal requirement that practitioners obtain a DATA-Waiver or X-Waiver to prescribe medications, like buprenorphine, to treat patients with opioid use disorder, in accordance with Section 1262 of the Consolidated Appropriations Act, 2023. Providers who have a current license to practice and a Drug Enforcement Administration (DEA) registration authorizing the prescribing of Schedule III drugs may prescribe buprenorphine for the treatment of opioid use disorder or pain management.
Summary: This amendment expands Peer Support Services, which allows providers outside of the Community Mental Health Center (CMHC) network to employ Peer Support providers and to be reimbursed for providing Peer Support Services.