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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: Updates Delaware State Plan regarding telemedicine, specifically, to sunset telemedicine Attachment 3.1-A introductory pages 1-2 and to modify language in Attachment 4.19-B Page 24.
Summary: Establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished concerning participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
Summary: This amendment looks to implement updates to physician, medical clinic, DME/MEDS fee schedules, increase rates for Etonogestrel implant system LARC devices, add a code for monkeypox testing to select fee schedules, and update DME/MEDS fee schedule. This SPA also removes age limits for naturopath coverage and expands coverage for behavioral health clinicians to include associate practitioners.
Summary: This amendment proposes to update mental health services provided under the rehabilitative services benefit to align with the department’s California Advancing and Innovating Medi-Cal (CalAIM) initiative. Specifically, the SPA removes the existing client plan requirement, clarifies site requirements for Day Rehabilitation, and makes other minor changes to service definitions and requirements.
Summary: Provides authority for coverage and payment of targeted case management for individuals age 18 and older who meet Medicaid eligibility requirements, have a chronic or complex physical or behavioral health need, and were recently incarcerated.
