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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: To amend the Plan's coverage of prescription and over-the counter tobacco cessation drugs in order to reflect new policy of the Affordable Care Act.
Summary: This Amendment proposed changes in pharmacy coverage required by Section 175 of the Medicare Improement for Patients and Oroviders Act of 2008 which amended section 1860D-2 (e) 2 (A) of the Act in include barbiturates" used in the treatment of epilepsy, cancer, or chronic mental health disorder" and benzodiazepines in Part D drug coverage.
Summary: Removes barbiturates benzodiazepines and agents used to treat smoking cessation from the list of drugs a Medicaid program may exclude from coverage or otherwise restrict.
Summary: Temporarily activates payment for CPT code 90686 influenza vaccine for Medicaid recipients who are pregnant and age 21 and older, in addition to the current coverage for birth through 20 years of age.
Summary: SPA adds changes to reimbursement for the MIC KEY Percutaneous Cecostomy tube MIC Button used tin the treatment of fecal incontinence. This also expands coverage of the MIC KEY Gastrostomy tube to include ages 21 and older.
Summary: Remove barbiturates benzodiazepines and agents used to treat smoking cessation from the list of drugs a Medicaid program may exclude from coverage or otherwise restrict.
