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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: Description: Proposes to permit the District of Columbia Medicaid program to effectuate the coverage of doula services, effective October 1, 2022.
Summary: Updates the State Plan language regarding the Community First Choice program to accurately reflect the highest allotted budget for personal Assistance Services based on the Resource Utilization Groups (RUG), which is $43,680 annually.
Summary: This SPA is to amend the provisions governing personal care services worker qualifications in order to remove minimum education and experience qualifications language.
Summary: This amendment proposes to update the legal name of GA Medicaid’s medical management and utilization review vendor, remove the list of specific items and services deemed experimental or investigational, and correctly reflect the non-covered services and procedures.
Summary: This amendment Implements Uniform Service Standards for behavioral health services including simplification to the diagnostic assessment process.
Summary: CMS is approving DE-19-0009 which amends the State Plan to allow Medicaid beneficiaries to request coverage from pharmacies of select FDA approved over-the-counter medications through an agreement with the Department of Public Health Medical Director for the purpose of generating a prescription and clarifies the coverage policy related to drugs indicated for the treatment of obesity.
Summary: To establish a targeted case management benefit for Medicaid eligible pregnant and post-partum individuals who are in the Drug Free Moms and Babies (DFMB) program.
