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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 SPA proposes to update language and the reimbursement methodology for 340B Antihemophilic Factor products and Physician Administered Drugs.
Summary: This SPA proposes to allow for certain medications to be filled in 90-day supplies. This is a change the state made during the COVID-19 Public Health Emergency (PHE) period, and this SPA seeks to extend the provision beyond the PHE timeframe.
Summary: CMS is approving this state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the increase to the the pharmacy dispensing fee that was approved in Section D.8 of DR SPA KS-20-0012.
Summary: CMS is approving DE-19-0009 which amends the State Plan to allow Medicaid beneficiaries to request coverage from pharmacies of select FDA approved over-the-counter medications through an agreement with the Department of Public Health Medical Director for the purpose of generating a prescription and clarifies the coverage policy related to drugs indicated for the treatment of obesity.
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 state rule beneficiary signature requirements for outpatient Rx drug pickup/delivery from 4/4/20-5/20/21. Add a $500 add-on per ventilation bed day to chronic disease hospital per diem rate from 10/1/21-6/30/2022 and add COVID vaccination administration reimbursement for dentists 12/11/20 through the end of the PHE and for hygienists from 12/11/20-4/14/22.
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 revise the percentage of net invoice cost paid for Outpatient Hospital Physician Administered Drugs.
Summary: This amendment updates the State's Supplemental Rebate Agreement’s (SRA) applicable date of the new Sovereign States Drug Consortium (SSDC) rebate agreement.
Summary: CMS approves Minnesota's time-limited COVID-19 disaster relief proposal. Effective March 1, 2020 per Section 7.4 of the Minnesota State Plan, the Minnesota State Medicaid agency waives signature requirements for the dispensing of drugs during the Federal COVID-19 Public Health Emergency.
