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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 provides attestation to coverage of usual and customary care for Wisconsin Medicaid beneficiaries participating in clinical trials as required by the Consolidated Appropriations Act of 2021 Effective January 1, 2022.
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 implement coverage of COVID-19 vaccine administration and COVID-19 Test administration when provided by pharmacists, pharmacy interns and pharmacy technicians, to the extent authorized by the PREP Act; and 2) Effective December 11, 2020, establish reimbursement rates for the COVID-19 vaccine administration at 100% of the Medicare rate.
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 allow for hospitals to be reimbursed for nursing facility level of care in cases where the hospital is unable to find a nursing facility placement effective 12/1/21.
Summary: The purpose of this SPA is to allow for passive enrollment of BadgerCare Plus and SSI-Related Medicaid beneficiaries, who are required to join a Health Maintenance Organization, effective December 11, 2021.
Summary: This amendment proposes to update the third-party liability and the Health Insurance Premium Payment program (HIPP) sections of the state plan.
Summary: This state plan amendment (SPA) removes Chiropractic services for individuals over the age of 21 from the Wyoming State plan as approved by the Wyoming Legislation.
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 hospital swing bed services in cases where a nursing home bed is not available.
