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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 revises the state plan to incorporate language that authorizes the state to enter into value-based contract arrangements with drug manufacturers through supplemental rebate agreements.
Summary: This amendment reimburses certain physician administered drugs (PAD), referred to as Clinician Administered Drug and Implantable Drug System Devices (CADDs), using the state's existing lesser of methodology under the pharmacy reimbursement methodology.
Summary: This SPA proposes to provide triennial assurance of the pharmacy program adherence to the requirements of federal regulation for the time period October 1, 2012 through September 30, 2015.
Summary: This adjusts the professional dispensing fee from $10. 02 to $10. 07 per prescription, based on a recent cost of dispensing survey of lowa Medicaid enrolled pharmacy providers.
