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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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to authorize an additional payment for administering in-home COVID-19 vaccinations to Medicaid members who have difficulty leaving their homes or are otherwise hard-to-reach.
Summary: Effective April 1, 2021, this amendment increases the rates for therapeutic phlebotomy under the Outpatient hospital and physician services benefit.
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 provide a supplemental payment of $15 per diem to eligible residents for services provided in nursing facilities and nursing facilities for mental health through a one time lump sum payment.
Summary: Effective effective October 1, 2020 until September 30, 2025, this amendment implements the time-limited mandatory medication assisted treatment benefit (MAT) per section 1006(b) of the SUPPORT Act to address opioid addiction. Section 1006(b) of the SUPPORT for Patients and Communities Act (SUPPORT Act), signed into law on October 24, 2018, amended section 1902(a)(10)(A) of the Act to require state Medicaid plans to include coverage of MAT for all eligible to enroll in the state plan or waiver of state plan. Section 1006(b) also added a new paragraph 1905(a)(29) to the Act to include the new required benefit in the definition of “medical assistance” and to specify that the new required benefit will be in effect for the period beginning October 1, 2020, and ending September 30, 2025.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to increase reimbursement for COVID-19 vaccine administration from $14.15 to $40.00.
