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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 proposes to change the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: Establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished concerning participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
Summary: This SPA introduces methods and standards for establishing payment rates for Inpatient Hospital Services and payments for Graduate Medical Education.
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 waive any signature requirements related to the dispensing of prescription drugs during the COVID-19 public health emergency (PHE).
Summary: To remove the expiration date from PR SPA 21-0011 and add language to keep the Puerto Rico Local Poverty Level at 85 percent of the federal poverty level.
Summary: To remove the expiration date from PR SPA 21-0012 and modify the income disregard for certain categorically needy and medically needy eligibility groups in the Puerto Rico Medicaid program.
Summary: Coverage and reimbursement of COVID-19 vaccines and vaccine administration, coverage and reimbursement of COVID-19 testing, coverage and reimbursement of services for the treatment and prevention of COVID-19, including conditions that may seriously complicate the treatment of COVID-19.
Summary: Tennessee is submitting this SPA to transfer responsibilities for surveying healthcare facilities in Tennessee from the Department of Health to the Health Facilities Commission (HFC).
Summary: This SPA update Third Party Liability (TPL) requirements as authorized under the Bipartisan Budget Act (BBA) of 2018 (Pub. L. 115- 123) and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019 (Pub. L. 116-16).
