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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: 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 homemaker services during the COVID-19 public health emergency (PHE) for Idaho’s 1915(i) HCBS Adult Developmental Disability Program. The SPA also authorizes a waiver of signatures for drug dispensing during the PHE.
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 time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow individuals who are evacuated or absent from the state due to the public health emergency and who intend to return to the state to continue to be residents of the state, extend eligibility redetermination timeframes for certain beneficiaries to 12 months, waive certain cost-sharing for COVID-19 related services, adjust certain state plan benefits, extend timelines for submission to CMS of cost reconciliation and settlement for school-based providers, and allow for the payment of additional therapeutic leave days for nursing facilities.
Summary: Proposes to allow 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 transmittal aligns the Idaho state plan in accordance with the Covered Outpatient Drug final rule, specifically the reimbursement of Physician Administered Drugs, and 340B contract drugs.
Summary: This transmittal aligns the Idaho SPA in accordance with the actual acquisition cost (AAC) reimbursement requirements under the Covered Outpatient Drugs final rule.
Summary: This SPA provides federally qualified health centers (FQHCs) and rural health centers (RHCs) with reimbursement for long acting reversiblecontraceptives (LARCs) and non-surgical trans-cervical permanent contraceptive devices outside of the encounter rate.
Summary: This amendment proproses to add compounded prescriptions, Mozobil, Ranexa, Rilutek, Soliris, and Xenazine to the list of drugs that require prior authorization.
