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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 reimburse for the COVID-19 vaccine administration during the COVID-19 Public Health Emergency (PHE) at 100% of the corresponding Medicare reimbursement rate at the time the service is provided. For any COVID-19 vaccine administration by a Tribal 638 non-FQHC clinic provider that would not otherwise have qualified for an All Inclusive Rate (AIR) payment, the COVID-19 vaccine administration will be reimbursed based on the fee schedule rates established in this SPA. The SPA also clarifies that pharmacies are qualified providers of COVID-19 vaccinations per the HHS COVID-19 PREP Act Declaration and authorizations and that pharmacy technicians and pharmacy interns acting within their scope of practice may administer the COVID-19 vaccination under the supervision of an immunizing pharmacist. This SPA also applies the newly added benefit to the Alternative Benefit Plan (ABP) population.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. reimburse 100% of Medicare for COVID laboratory testing and COVID laboratory specimen collection.
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 authorize administration of COVID-19 vaccines with a FDA Emergency Use Authorization (EUA) status, without regard to the state's limitation on coverage of experimental procedures or services. This SPA also authorizes COVID drug treatments that may be provided under EUA without regard to rebate status.
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 flexibility in the setting where autism treatment services are provided and face-to-face requirement during service provision.
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 increase certain payment rates and to allow additional providers the ability to order Home Health services including Durable Medical Equipment.
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 request coverage and reimbursement for PREP Act qualified professionals, including but not limited to pharmacists, for administration of all ACIP-recommended vaccines and seek coverage and reimbursement of administration of the COVID vaccine and countermeasures for physicians and other PREP Act qualified professionals, including pharmacists.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. This SPA modifies the criteria for ambulance transportation between two hospitals.
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 pharmacists to order and administer vaccines, including the COVID-19 and influenza vaccines. The amendment also permits pharmacy technicians and pharmacy interns to administer the COVID-19 and influenza vaccines under the supervision of an immunizing pharmacist.
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 implement a temporary rate increases of 2.3% for home health aide services provided by home health agencies, specifically HCPCS T1004, T1021 effective Sept 1 through October 31, 2020.
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 waive or modify certain requirements of Title XIX of the Act to address the COVID-19 public health emergency, in order to provide a one-time lump sum payment to privately owned and operated intermediate care facilities (ICF) for individuals with intellectual disabilities (IID), and a one-time lump sum payment for Long Term Personal Care Services providers.
