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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 reimburses certain physician administered drugs (PAD), referred to as Clinician Administered Drug and Implantable Drug System Devices (CADDs), using the state's existing lesser of methodology under the pharmacy reimbursement methodology.
Summary: This modifies the Graduate Medical Education (GME) Innovations Grant agreement to reflect a change in hospital partnership and an increase in the agreement amount funding available to providers in the state of Michigan providing accredited psychiatric residency training.
Summary: Revises the current Supplemental Drug Rebate Agreement (SDRA) to be consistent with the Covered Outpatient Drug final rule with comment period (CMS-2345-FC) and to revise references to various federal laws and definitions that have been changed.
Summary: To revise the payment methodology for prescription drugs at point-of-sale (POS) pharmacies and describe reimbursement for 340B covered entities effective April 1, 2017.
Summary: To define coverage and the reimbursement methodology for physician administered drugs, implantable drug system devices, diagnostic or therapeutic radiopharmaceuticals and contrast imaging agents in the office setting, effective.
Summary: This amendment proposes to revise the Sovereign States Drug Consortium (SSDC) Supplemental Rebate Agreement (SRA) previously submitted to CMS on September 12, 2012, to allow supplemental rebates to be collected on coordinated care claims. This amendment also implements a uniform Preferred Drug List (PDL) for fee-for-service and coordinated care pharmacy claims.
Summary: This SPA 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 502(a) of the Affordable care Act.
Summary: Includes Barbiturates "Used in the Treatment of Epilepsy, Cancer, or a Chronic Mental Health Disorder" and Benzodiazepines in Part D Drug Coverage.
Summary: This SPA allows the state to negotiate supplemental rebates for Medicaid covered outpatient prescription drugs to Mississippi beneficiaries using the Mississippi Medicaid Supplemental Drug Rebate Agreement and the Sovereign States Drug Addendum to the Member States' Agreements.
Summary: This amendment revises the State's reimbursement methodology for setting payment rates for hospital services. Specifically, it will amend the plan language to revise inconsistent and ambiguous language and correct examples of the rate setting methodologies.
