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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to establish a COVID-19 interim payment methodology for primary care medical providers (PCMP) who provide integrated services.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this SPA is to provide authority to address the National Emergency to allow Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), Tribal FQHCs, and Tribal Health Centers (THC) to be reimbursed for COVID-19 specimen collection when no other eligible qualifying clinic visit is provided on the same date of service. The State of Michigan is also requesting authority to allow for COVID-19 laboratory specimen collection to be reimbursed when provided by a licensed Pharmacist or Pharmacy Technician under the supervision of a Pharmacist as authorized by the State within their scope of practice.
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 add additional payment methodologies for home health and private duty nursing services.
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 permit the District of Columbia Medicaid program to make retainer payments to Adult Day Health Program (ADHP) providers whose operations have been impacted by the ongoing public health crisis related to COVID-19.
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 make 3 episodes of 30 consecutive days of retainer payments to providers of 1915 Pathways to Employment supported employment services. The state also temporarily increases the rate paid to providers by 5%
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 modify the other licensed practitioner benefit to allow licensed pharmacists within their state scope of practice with CLIA waiver certification to provide diagnostic COVID-19 antigen tests; and to reimburse pharmacists providing COVID testing using a state-developed fee schedule for diagnostic testing.
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 include additional coverage and payment for COVID-19 testing, add teledentistry to telehealth benefits, add publicly-owned hospitals to those eligible to receive supplemental payments, and to add qualifications for direct support professionals, mental health rehabilitation technicians and behavioral health professionals.
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 rescind the payment increases in Section 7.4, E.2.b.ii of the state plan.
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 make interim payments based on FFS utilization only to the fourteen (14) CMHCs that have had a decline in utilization due to the COVID-19 pandemic.
