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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: Physician Administered Drugs (PADS) submitted under the medical benefit, including those drugs purchased through the 340B program, will be reimbursed at Medicare Part B fee schedule rates.
Summary: This amendment requests an additional 2-year renewal of the exemption from the Recovery Audit Contractor program, from January 1, 2023 to December 31, 2024.
Summary: Renewing Idaho’s Home and Community Base Services (HCBS)1915, Yes Empowerment Services (YES) State Plan Benefit, targeting children with serious emotional disturbances (SED). This benefit will provide respite services for children and youth who have a substantial functional impairment that is measured by and documented through the use of a standardized instrument conducted or supervised by a qualified independent assessor clinician.
Summary: This State Plan Amendment is a technical correction to remove the word "dental" from the second paragraph of Attachment 4.19-B, #13. d. Page 1, and replace with the correct words "behavioral health".
Summary: With the approval of SPA KS-22-0018, a technical SPA is needed to correct the location of PADS for the reimbursement of LARC devices at Rural Health Centers (RHC) and Federally Qualified Health Centers (FQHC).
Summary: This amendment requests an additional 2-year renewal of the exemption from the Recovery Audit Contractor program, from January 1, 2023 to December 31, 2024.
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 rescind the authorities regarding Presumptive Eligibility (PE) authorized in sections B.1, B.2, and B.3 of DR SPA KS-20-0012. This will revert the State back to the practice of one PE period for parents or caretaker relatives, children, former foster care children; one PE period per pregnancy per a 12-month period; remove the state as a qualified entity; and eliminate the ability for qualified providers to determine eligibility for Parents/Caretaker Relatives and Former Foster Care Children.
