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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 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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to waive the signature requirements for the dispensing of drugs during the Covid-19 Public Health Emergency.
Summary: Proposes to allow the Alabama Medicaid Agency to enter into value/outcome(s) based agreements with drug manufacturers for purpose of collecting additional supplemental drug rebates
Summary: This SPA proposes to bring Alabama into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Summary: Removes barbiturates, benzodiazepines and agents used to promote smoking cessation from the list of drugs the state Medicaid program may exclude from coverage or otherwise restrict in order to comply with the requirements of Section 2502(a) of the ACA.
Summary: This SPA proposes to limit the number of outpatient pharmacy prescriptions for all recipients, with certain class exemptions, to five total drugs per month per adult recipient.
Summary: This SPA allows the Alabama Medicaid Agency to continue allowing eligible primary care physicians that practice in family medicine, general internal medicine or pediatric medicine to receive enhanced payments for certain specified procedure codes for elvaluation and management services and certain Vaccines for Children vaccine administration codes.
Summary: This SPA discontinue coverage of legend (prescription only) brand and generic agents used for symptomatic relief of cough and cold. The Agency will continue to cover certain over-the-counter (OTC) cough and cold products in an effort to provide cost effective alternatives to recipients.
