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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: 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.
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 waive any signature requirements for the dispensing of drugs during the Public Health Emergency.
Summary: This SPA attests to the state's coverage of COVID-19 vaccines and vaccine administration, COVID-19 testing, and COVID-19 treatment, as required by sections 1905(a)(4)(E) and 1905(a)(4)(F) of the Social Security Act.
Summary: Effective for services on or July 1,2021, this amendment updates the supplemental payment methodology to hospitals for inpatient and outpatient services. Specifically, these changes will associate supplemental payments with quality of services and participation in the Healthy Connections Value Care (HCVC) program, further linking inpatient and outpatient hospital services to quality and value of patient care.
Summary: This SPA clarifies that all vaccine administration services are paid at a rate of $4.00 unless otherwise specified, regardless of billing code. This SPA also sets the state's Monkey Pox vaccine administration rate equal to the Medicare geographic rate for COVID-19 vaccine administration, updating the effective date to 10/15/22 and the fee schedule links for Evaluation & Management Services (E&M) and vaccine administration.
Summary: This amendment updates the Alternative Benefit Plan (ABP) pages to align with the addition of the mandatory benefit that covers routine patient costs associated with participation in qualifying clinical trials approved in SPA 22-0004.
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.
