An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: Specifies how it will revise its pharmacy reimbursement methodology to comply with the key provisions of the Covered Outpatient Drug Final Rule with comment (81 FR 5170) that was published in the Federal Register on February 1, 2016.
Summary: The purpose of this SPA is to revise our outpatient pharmacy program to comply with the new reimbursement requirements in CMS'Covered Outpatient Drug final rule with comment CMS 2345-FC.
Summary: This SPA amends the limitations on prescription drug coverage to clarify that agents when used for cosmetic purposes or hair growth will only be covered when the state has determined that use to be medically necessary.
Summary: This amendment proposes to update the state Medicaid program' s drugs on which it may exclude from coverage or otherwise restrict in order to comply with the requirements of the 21' Century Cures Act.
Summary: Revise's Utah pharmacy reimbursement methodology to comply with the key provisions of the Covered Outpatient Drug Final Rule with Comment( 81 FR 5170) that was published in the Federal Register on February 1, 2016.
Summary: Updates the state plan to include utilization from participating MCOs for supplemental drug rebates for direct-acting antivirals for the treatment of hepatitis C.
Summary: Changes to the basis for ingredient cost reimbursement to comply with requirements of the Covered Outpatient Drug Final Rule with comment (CMS-2345-FC) (81 FR 5170) pertaining to drug reimbursement in the Medicaid program.
