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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: To add text to the State Plan regarding reimbursement practices for community mental health services and to reflect the inclusion of updated dental procedure codes in the agency's fee schedule.
Summary: To include the terms upon which the state will collect supplemental rebates from drug manufacturers on those drugs dispensed to Medicaid Managed Care Organizations (MCO) enrollees.
Summary: This SPA will allow Virginia to add the new annuity requirement that annuities purchased before February 8, 2006, but modified after that date would be subject to all requirements applicable to annuities purchased after February 8, 2006.
Summary: This SPA proposes to require a face-to-face encounter be performed by an approved practitioner with the Medicaid beneficiary in order for payment and delivery of Home Health Services under Medicaid.
Summary: This SPA eliminates outdated text and to include new text related to Addiction and Recovery Treatment Services that was not included in the 1115 Waiver that was approved by CMS on December 15, 2016.
Summary: This SPA proposes programmatic changes in the provision of Community Mental Health Rehabilitative Services in order to ensure appropriate utilization, provider qualifications, and cost efficiency appropriate to render these Medicaid covered services.
Summary: To include activities, interventions, and goal directed trainings that are designed to restore functioning and that are defined in an individual service plan.
Summary: This SPA proposes to establish a reconsideration process by which appellants can petition the Virginia Medicaid Agency's Director to reconsider the Department of Medical Assistance Services' (DMAS) Final Agency Decision. The SPA indicates that the DMAS Director's review shall be made upon the case record of the formal appeal. Testimony or documentary submissions that were not part of the formal appeal case record prior to the issuance of the Final Agency Decision shall not be considered.
Summary: Updates the general language and provider qualifications including requirements that all providers be certified by Virginia's Department of Behavioral Health and Developmental Services (DBHDS) as an intellectual disability case management agency.
