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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: Disregards portions of Social Security Disability Insurance (SSDI) income when calculating financial eligibility for certain sections 1915(c) waivers.
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: 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.
Summary: To adopt 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: Effective March 31, 2021, this amendment removes a limit for psychiatric hospitalization that prevented more than 21 days in a hospital in a 60-day period for the same or similar diagnosis or treatment plan and updates practitioner terminology as it relates to working titles.
Summary: Changes the eligibility section in the state plan to remove the requirement for 40 qualifying quarters of employment for lawful permanent residents.
Summary: The purpose of this SPA is to update the ARTS state plan pages to incorporate general updates to the program, including updates related to medication assisted treatment, defining the scope of practice for certified substance abuse counselors, including substance use disorder counseling within that scope, and guidance related to telemedicine requirements.
Summary: The purpose of this SPA is to amend the state plan to allow nurse practitioners, clinical nurse specialists, and physician assistants to order and certify home health services.
