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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 modifies the state’s paper and online applications to integrate eligibility for the state’s 1115 family planning demonstration waiver into the state’s Medicaid eligibility application and eligibility determination system. The changes are limited to inclusion of two additional questions to ensure an applicant can apply and be determined eligible for family planning coverage, as provided under Montana’s section 1115 family planning demonstration.
Summary: Effective March 1, 2021, this amendment updates the early and periodic screening, diagnostic, and treatment (EPSDT) fee schedule to add reimbursement rates for cranial remolding helmets.
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 authorize administration of COVID-19 vaccines with a FDA Emergency Use Authorization (EUA) status, without regard to the state's limitation on coverage of experimental procedures or services. This SPA also authorizes COVID drug treatments that may be provided under EUA without regard to rebate status.
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 allow flexibility in the setting where autism treatment services are provided and face-to-face requirement during service provision.
Summary: The purpose of this amendment is to establish an Alternative Payment Methodology for tribal health facilities that agree to enroll as a Tribal Federally Qualified Health Center (Tribal FQHC).
Summary: Updates the fee schedule to increase the reimbursement for cardiac catheterization to 80% of the annual non-rural Medicare rate, effective January 1, 2021.
