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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: Amendment to the State Plan to update the Private, State, and County-Owned Nursing Facility Supplemental Payment section to reflect changes requested by CMS before implementing the Department’s new Patient Driven Payment Methodology Upper Payment Limit (PDPM UPL) methodology.
Summary: This amendment is to include pharmacists as a recognized practitioner type allowed to charge for services given to Medicaid clients under Attachment 3.1-A, Section 6.d. and Attachment 4.19-B, Section 6.d of the state plan.
Summary: Amendment to the State Plan to implement a new price-based methodology for private nursing facilities and cost-based methodology for state-owned nursing facilities.
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: 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 SPA amendment is to elect the option described in section 1902(e)(16) of the Social Security Act to provide 12 months of postpartum coverage to Medicaid-eligible pregnant individuals.
Summary: The purpose of this SPA is to comply with the requirements within section 1905(a)(4)(F) of the Social Security Act to cover COVID-19 vaccines, vaccine administration, testing and treatment.
