An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: Changes to the early and periodic screening, diagnostic and treatment benefits, and related payment methodologies. The proposed changes align payments for direct medical services, which are outlined in an individualized education plan and supplied in a school-based setting, to actual costs for providing these services.
Summary: Allow qualified licensed pharmacists to provide Medicaid services within their scope of practice. This change will expand the number of providers who are able to supply benefits to Medicaid beneficiaries and permit these providers to bill for these services.
Summary: This amendment proposes to expand the criteria for allowable providers of Developmental, Individual Differences, and Relationship-based (DIR)/Autism Services. This change is expected to improve access to services for eligible beneficiaries with an autism spectrum disorder diagnosis by increasing provider enrollment and making DIR services more readily available state-wide.
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 for one year the following disaster relief flexibilities: targeted case management, telehealth, drug benefit, and behavioral health home requirements.
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 signature requirements for the dispensing of drugs during the PHE.
Summary: This amendment adds assurances that the state covers and reimburses COVID-19 vaccine administration, testing, and treatment as required under section 9811 of the American Rescue Plan Act of 2021.
Summary: Adds peer support and coordination services, which are provided to individuals after an opioid overdose, to the state’s Alternative Benefit Plan (ABP). These peer support and coordination services have been added to the benefit package in the Medicaid state
plan and this SPA would align the benefits of both benefit packages.
