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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: Adds licensed professional counselors and licensed marriage and family therapists to the core services proved by Federally Qualified Health Centers and Rural Health Clinics. The amendment also added pharmacists and licensed dietician-nutritionists to the list of other ambulatory services offered by Federally Qualified Health Centers and Rural Health Clinics.
Summary: This SPA authorizes increased FFP for newly-eligible individuals receiving postpartum coverage and further includes the addition of Attachment D, which describes the special circumstances and other proxy adjustments that are applied to account for the proportion of individuals covered under the extended postpartum coverage option who would otherwise be eligible for coverage in the adult group and for the newly eligible FFP under section 1905(y) of the Social Security Act.
Summary: Pursuant to state legislation that rescinds Medicaid coverage and payment provisions for outpatient health facilities (OHF), this SPA proposes to remove the obsolete Attachment 3.1-A and 4.19-B pages from the Medicaid State Plan.
Summary: This amendment proposes to remove the optional service, case management of high-risk pregnant women, from the Delaware Medicaid State Plan as these services will now be provided via an evidence-based home visiting model under 1115 waiver authority, effective January 1, 2023.
Summary: This amendment for Clinic Services addresses the compliance concerns raised in the February 24, 2023 companion letter, for an April 1, 2023, effective date.
Summary: To add transportation as an allowable rural health clinic service and dietician services as allowable rural health clinic and federally qualified health center services.
Summary: This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.
