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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 will clarify the state covers and reimburses approved adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
Summary: The primary purpose for this amendment is to make enhanced payments to physicians associated with certain publicly owned or operated hospitals.
Summary: This SPA proposes to update the state's Excluded Drug list, to include amending the language provisions for coverage of selective non-prescription covered outpatient drugs.
Summary: This amendment establishes compliance with the mandatory coverage and reimbursement of routine patient costs associated with participation in qualifying clinical trials under Sections 1905(a)(30) and 1905(gg) of the Social Security Act.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend the suspension of Medicaid copayments for all items and services for all eligibility groups until Sept. 30, 2024.
Summary: This amendment clarifies the assurance that Guam provides EPSDT services pursuant to sections 1902(a)(10)(A), 1905(a)(4)(B), and 1905(r) of the Social Security Act.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend the increased nursing facility per diem rate through June 30, 2023.
