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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 plan amendment authorizes the Department to make an additional payment to nonpublic and county nursing facilities that qualified for supplemental ventilator care and tracheostomy care payments in a city of the first class.
Summary: This amendment provides coverage without cost sharing for adult vaccines and their administration for all U.S. Food and Drug Administration approved adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
Summary: Aggregate Limits to Inpatient Disproportionate Share, Outpatient Supplemental and Direct Medical Education and Disproportionate Share Hospital and Supplemental Payments to Newly Enrolled In-State Hospitals that Qualify for Payments
Summary: This amendment establishes compliance with the mandatory coverage and reimbursement of routine patient costs associated with participation in qualifying clinical trials under Sections 1905(a)(30) and 1905(gg) of the Social Security Act.
Summary: Makes a DSH payment add-on per FFS and managed care day; the daily add-on is tiered dependent on the qualifying facility's Medicaid day to total ratio. This additional DSH pool will not be redistributed if overpayments occur, but recouped and federal share returned.
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 provide one-time lump sum supplemental payments to non-emergency medical transportation (NEMT) providers for the period beginning July 1, 2022 through April 30, 2023. This amendment also waives signature requirements for the dispensing of drugs during the public health emergency, effective March 1, 2020.
Summary: This amendment clarifies the assurance that Guam provides EPSDT services pursuant to sections 1902(a)(10)(A), 1905(a)(4)(B), and 1905(r) of the Social Security Act.
