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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: Allows the Division of Medicaid (DOM) to set the fees for DPSDT extended services to the same as those in effect on July 1, 2020, to remove the five percent (5%) reimbursement reduction effective July 1, 2021, and add coverage and reimbursement of Mississippi Youth Programs Around the Clock (MYPAC) Therapeutic Services effective July 1, 2021.
Summary: Effective October 1, 2020 until September 30, 2025, this amendment addresses the newly added mandatory benefit for coverage and reimbursement of medication-assisted treatment (MAT) in opioid treatment programs (OTPs) and office-based opioid treatment settings. The purpose of the SPA is to move Virginia’s current MAT benefit from the optional benefit section in Virginia’s state plan to the required benefit section to comply with Section 1006(b) of the SUPPORT Act.
Summary: Moves Oregon’s current Medication Assisted Treatment (MAT) benefit from the optional benefit section in Oregon’s state plan to the required benefit section to comply with Section 1006(b) of the SUPPORT Act.
Summary: Effective October 1, 2019, this amendment allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Summary: Effective January 1, 2021, this amendment eliminates the monthly six prescription limit and one dollar per prescription (or refill) copayment.
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 update the State Plan to include emergency provisions including: suspension of co-payments, adjust current benefits, expand telemedicine services, increase payment rates, eliminate sanctions for cost reports, and modify occupancy limits.
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 increase the dispensing fee for curbside pharmacy services.
