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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 changes to Hospital Presumptive Eligibility (HPE) to include the adult group in the eligibility groups for which hospitals may conduct HPE determinations.
Summary: This amendment authorizes the administration of immunizations recommended by the Advisory Committee on Immunization Practices (ACIP) by licensed pharmacies, pharmacists, pharmacy interns, and pharmacy technicians
Summary: This amendment proposes to assure the American Rescue Plan Act’s (ARP) mandatory coverage of the COVID-19 vaccine, testing, and treatment without cost sharing.
Summary: This amendment proposes to add doula service coverage, providing emotional, physical, and informational support services during the prenatal, labor and delivery, and postpartum periods.
Summary: 23-0020 which proposes an enhanced payment for intermediate care facilities for individuals with intellectual disabilities that provide vocational services or day program services or both.
Summary: This amendment ensure that the agency's cost-sharing authority reflects co-payments that are currently in practice. This request also seeks to remove cost sharing for vaccine administration per the Inflation Reduction Act provision prohibiting cost sharing for Advisory Committee on Immunization Practices (ACIP) recommended vaccines for adults.
Summary: Pregnant Woman Proxy Payment Methodology-state plan amendment is needed to describe the payment methodology for Hawaii selection in SPA 22-0008 to extend medicaid coverage post-pregnancy from 60 days to 12 months.
