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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 proposes to implement temporary policies, which are different from those policies and procedures otherwise applied under your Medicaid state plan, during the period of the Presidential and Secretarial emergency declarations related to the COVID- 19 outbreak (or any renewals thereof).
Summary: Updates the outpatient pharmacy rate methodology for blood clotting factor drugs by incorporating Average Acquisition Cost (AAC) and Clotting Factor Maximum Allowable Cost (CFMAC) rates, along with a $0.03/unit enhanced professional dispensing fee.
Summary: Changes the policy for reimbursement of child-serving residential facilities to include only facilities that are 16 or fewer beds and are exclusively for treatment purposes. This includes the new Qualified Residential Treatment Program (QRTP) license type and Substance Use Disorder (SUD) providers.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to extend the increased payments for nursing facilities and ICF/IIDs under Attachment 4.19-D to June 30, 2021.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to establish a July 2021 COVID-19 interim payment for primary care medical providers (PCMP) who provide integrated services. PCMPs who received a February 2021 (approved in TN 21-0003) or October 2020 COVID-19 interim payment (approved in TN 20-0035) are not eligible to receive the July 2021 COVID-19 interim payment.
Summary: This plan amendment allows an increase to certain Medicaid provider rates by 2.5% for specific services in accordance with the 2021 Long Bill (SB21-205) for the State of Colorado
Summary: We have reviewed the proposed Colorado State Plan Amendment (SPA) to Attachment 4.19-B of your state plan, which was submitted to the Centers for Medicare & Medicaid Services (CMS) on July 01, 2021. This plan amendment provides a 2.5% rate increase for outpatient hospital services.
