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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 SPA eliminates the “deprivation” requirement relating to dependent children living with individuals who seek Medicaid on the basis or being parents and other caretaker relatives.
Summary: This amendment is to comply with mandatory Medicaid coverage of routine patient costs furnished in connection with participation in qualifying clinical trials.
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 temporarily eliminate the "Deprivation" requirement relating to dependent children living with individuals who seek Medicaid on the basis of being parents and other caretaker relatives.
Summary: This amendment adds optometry services to the state plan, revises coverage of eyeglasses/contact lens, and adds a fee-for-service payment methodology for these benefits.
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: This state plan amendment (SPA) removes Chiropractic services for individuals over the age of 21 from the Wyoming State plan as approved by the Wyoming Legislation.
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.