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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: This amendment is to add Elevated Blood Lead (EBL) level education visits for children under 21 years of age, and Lead Hazard Risk Assessments for children under 21 years of age.
Summary: This amendment is to add coverage for the human papillomavirus (HPV) vaccine for persons 46 years of age or older who meet certain medical criteria.
Summary: This amendment is to add Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) to the FQHC and RHC sections of its Medicaid State Plan to be in compliance with CAA 2023.
Summary: Allow qualified licensed pharmacists to provide Medicaid services within their scope of practice. This change will expand the number of providers who are able to supply benefits to Medicaid beneficiaries and permit these providers to bill for these services.
Summary: This amendment authorization is for Health First Colorado to obtain reimbursement for Partial Hospitalization services as defined by the American Society of Addiction Medicine’s 2.5 standards.
Summary: This amendment updates the Medicare fee schedules, MO HealthNet fee schedules, and the National Dental Advisory Service (NDAS) used to determine outpatient reimbursement rates.
Summary: This amendment is to include Autism Services for Children on Medicaid under the preventative benefit adding applied behavioral analysis (ABA) services for children.
