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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: The SPA provides assurances that the State complies with federal requirements regarding coverage of routine patient care associated with participation in clinical trials as required by the Consolidated Appropriations Act, 2021.
Summary: To allow the District to transition its Section 1115 Behavioral Health Transformation Demonstration Program services to permanent State Plan authority in order to retain authority to provide Medicaid reimbursement.
Summary: This SPA amends to add coverage of routine patient costs associated with participation in qualifying clinical trials to conform with the new regulatory requirements of 1905(a)(30) and 1905(gg) of the Social Security Act (SSA).
Summary: This amendment provides attestation to coverage of usual and customary care for Wisconsin Medicaid beneficiaries participating in clinical trials as required by the Consolidated Appropriations Act of 2021 Effective January 1, 2022.
Summary: SPA was submitted in order to implement Maine’s Primary Care Plus (PCPlus) Program, intended to replace the three existing primary care programs in the state with a single simplified and integrated program.
Summary: The SPA provides assurances that the State complies with federal requirements regarding coverage of routine patient care associated with participation in clinical trials as required by the Consolidated Appropriations Act, 2021.
Summary: To update the State Plan language to comply with the amended section 1905(a)(30) of the Social Security Act, assuring coverage to eligible Medicaid participants for routine patient costs for otherwise covered items and services resulting from a qualifying clinical trial.
Summary: This SPA proposes to add provisions which will allow the coverage of routine patient costs furnished in connection with participation with qualifying clinical trials
Summary: This amendment proposes to add optometrist services to the prospective payment system (PPS) rates for Federally Qualified Health Centers (FQHC) and Rural Health Centers (RHC).
