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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: Effective April 1, 2020, this amendment proposes to provide Medicaid coverage of durable medical equipment to support beneficiaries' mobility-related activities of daily living.
Summary: Effective August 19, 2020 this amendment adds coverage and reimbursement for three evidence-based parenting programs for children with disruptive behavior disorders.
Summary: This amendment proposes adding coverage and payment methodology of Personal Care Attendant Services (PCAP) in the U.S. Virgin Islands Medicaid program, approved initially on March 25, 2021. At the time of approval, the end of the PHE was not known. Now that the date is known, this SPA has been updated to reflect an effective of May 12, 2023.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to update Payment Methodologies for Certain Hospital, Community Health Centers, Physician, and coverage for mobile testing service done by EMTs during the COVID-19 Emergency period.
Summary: Allows the Division of Medicaid to add coverage of licensed pharmacists under the Other Licensed Practitioners (OLP) for vaccine administration.
Summary: This SPA proposes to allow coverage for select maintenance drugs for up to 90 days for Medicaid members after the end of the federal emergency period.
Summary: Establishes an alternative payment methodology for Rural Health Clinics based on 100% of the average of the reasonable cost of providing MaineCare-covered services during calendar years 2016 and 2017
Summary: Updates coverage and documentation requirements for enteral nutrition and allow the use of implantable pumps for delivering home infusion therapy
