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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: Effective February 1, 2021, this amendment proposes to align Medicaid COVID-19 vaccine administration rates with Medicare rates and to allow other licensed practitioners such as pharmacists and pharmacy technicians to administer the COVID-19 vaccine.
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 allow pharmacists to order and administer certain Covid-19 vaccines, including Pfizer and Moderna vaccines currently available, where a pharmacist has met CMS training requirements and state regulations for training and vaccine administration.
Summary: Effective March 1, 2021, this amendment solicits advice from Tributes and Indian Health Programs, prior to submitting any plan amendments, waiver requests, and proposals for demonstration projects that are likely to have a direct effect on Indians, Indian Health Programs, or Urban Indian Organizations.
Summary: Effective March 1, 2020, this amendment establishes coverage of COVID-19 vaccine administration and a reimbursement rate for COVID-19 vaccine administration for providers reimbursed on a fee-for-service basis.
Summary: Effective January 1, 2021, this amendment updates the reimbursement methodology for tribal providers rendering residential substance use disorder (SUD) services.
Summary: The purpose of this amendment is to establish an Alternative Payment Methodology for tribal health facilities that agree to enroll as a Tribal Federally Qualified Health Center (Tribal FQHC).
Summary: Allows the Division of Medicaid to add coverage of licensed pharmacists under the Other Licensed Practitioners (OLP) for vaccine administration.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this SPA is to provide authority to address the National Emergency to allow Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), Tribal FQHCs, and Tribal Health Centers (THC) to be reimbursed for COVID-19 specimen collection when no other eligible qualifying clinic visit is provided on the same date of service. The State of Michigan is also requesting authority to allow for COVID-19 laboratory specimen collection to be reimbursed when provided by a licensed Pharmacist or Pharmacy Technician under the supervision of a Pharmacist as authorized by the State within their scope of practice.
Summary: Authorizes 100% FFP for services provided by non-IHS/Tribal providers to Medicaid-eligible individuals who are Tribal Medicaid beneficiaries when the provider has a written care coordination agreement with an IHS/Tribal facility.
