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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: Proposes to allow the state to enter into a single, state-specific Supplemental Rebate Agreement (SRA) with drug manufacturer(s). The state will initially focus on providing an unlimited supply of HCV antiviral agent drugs, in exchange for the state paying a capped amount of money each year for these drugs.
Summary: Proposes to allow the state to directly negotiate supplemental Value Based Purchasing (VBP) agreements with drug manufacturers. This SPA will be used by the state in particular to address the hepatitis C (HCV) virus patient population by allowing it to contract with a manufacturer(s) under a subscription model, allowing the state to purchase an unlimited amount of HCV direct-acting antivirals as needed for a fixed fee and time period. Once approved, this SPA will be the 4th Value Based Purchasing Supplemental Rebate Agreement that CMS has authorized.
Summary: Changes the pharmacy ingredient cost reimbursement methodology from a Louisiana average acquisition cost (AAC) to the national average acquisition cost (NADAC).
