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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 updates the reimbursement methodology for durable medical equipment/supplies and allows for a non-rural and rural rate according to the member's physical address.
Summary: This amendment is to add coverage and reimbursement for services provided by licensed podiatrists under the other licensed practitioner benefit.
Summary: The purpose of this SPA to implement mandatory coverage and reimbursement of COVID-19 testing, vaccine and vaccine administration, and treatment in accordance with Section 9811 of the American Rescue Plan (ARP) Act.
Summary: This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement coverage of COVID-19 vaccine administration and COVID-19 Test administration when provided by pharmacists, pharmacy interns and pharmacy technicians, to the extent authorized by the PREP Act; and 2) Effective December 11, 2020, establish reimbursement rates for the COVID-19 vaccine administration at 100% of the Medicare rate.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow the territory to consider individuals absent from the territory to continue to be residents; to provide rate increases for FQHC medical encounters rendered at government quarantine locations; to create payment methodology for local non-government dialysis centers in AS during the PHE period; to revise the payment methodology for off-island dialysis; and to revise payment methodology for transportation and related accommodations associated with return from off-island medical care.
