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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 increase the annual dental cap for adults from $1,000 to $1,500 and to allow emergency dental services for adults to be covered after the annual cap on dental expenditures has been met.
Summary: This SPA permits licensed pharmacists to enroll in the Vermont Medicaid program, allowing coverage of COVID-19 diagnostic testing and specimen collection by licensed pharmacists to the extent permitted by state and federal law.
Summary: This SPA transmitted a proposed amendment to your approved Title XIX State plan to implement Section 6401(a) of the Affordable Care Act . This Affordable Care Act provision amended section 18660) of the Social Security Act to add a new paragraph ''(2) Provider Screening."
Summary: This SPA amends the State's approved Title XIX State Plan to reduce the current Medicaid reimbursement methodology for limited distribution specialty pharmacies from average wholesale price (AWP) minus 14.2 percent to 16.5 percent, cover generic over-the-counter drugs when medically necessary without the option of prior authorization for brand name drugs and cover active pharmaceutical ingredient (API) drugs.
Summary: This SPA transmitted a proposed amendment to your approved Title XIX State plan to implement section 4107 of the Affordable Care Act. This Affordable Care Act provision amended section 1905(a)(4) of the Social Security Act to add a new subsection (D) to provide Medicaid coverage of comprehensive tobacco cessation services for pregnant women. including both counseling and pharmacotherapy. without cost sharing.
