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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: Proposes to make changes to post-eligibility treatment of income (PETI) by imposing reasonable limits on deductions for incurred medical or remedial care expenses
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 add nursing rate for Personal Care Attendant Services and a flat nursing rate for the initial assessment to the U.S Virgin Islands Medicaid State Plan for both the categorically needy and the medically needy populations.
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 cover COVID-19 vaccine administration using the Medicare Suburban Chicago FFS rate statewide and to recognize pharmacies and pharmacy professionals as qualified providers of COVID-19 vaccines per the HHS PREP Act.
Summary: Effective January 1, 2021, this amendment increases dental rates for services provided by dental practice plans operated by publicly funded academic medical centers.
Summary: Effective October 1, 2019, this amendment allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Summary: This amendment proposes adding coverage and payment methodology of Personal Care Attendant Services (PCAP) in the U.S. Virgin Islands Medicaid program, approved initially on March 25, 2021. At the time of approval, the end of the PHE was not known. Now that the date is known, this SPA has been updated to reflect an effective of May 12, 2023.
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 add providers and specify provider qualifications (training and supervision requirements) as well as, to clarify 15 minute increment payment policy.
