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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 will clarify the state covers and reimburses approved adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
Summary: This amendment is submitted to add lactation services and the Advisory Committee on Immunization Practices (ACIP) adult vaccine assurance to the preventive services benefit.
Summary: This SPA waives Northern Mariana from participation in the Medicaid Drug Rebate Program (MDRP) under the authority of 1902(j) of the Social Security Act.
Summary: This amendment proposes to revise the North Carolina Point of Sale reimbursement policies and titles, and to allow North Carolina licensed and certified clinical pharmacist practitioners to administer services within the scope of their practice.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to increase the current COVID-19 Vaccine Administration Fee from $13.23 per dose to $40.00 per dose to all qualified Medicaid enrolled health care providers except when it is a Federally Qualified Health Center or Rural Health Center encounter.
Summary: Effective February 1, 2021, this amendment proposes to align Medicaid COVID-19 vaccine administration rates with Medicare rates and to allow other licensed practitioners such as pharmacists and pharmacy technicians to administer the COVID-19 vaccine.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow pharmacists to order and administer certain Covid-19 vaccines, including Pfizer and Moderna vaccines currently available, where a pharmacist has met CMS training requirements and state regulations for training and vaccine administration.
Summary: Allows the Division of Medicaid to add coverage of licensed pharmacists under the Other Licensed Practitioners (OLP) for vaccine administration.
