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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 rescind the Disaster Relief provision to expand medication prior authorizations to allow renewal automatically without clinical review or time/quantity extensions.
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 amend the current payment methodology to a cost-based payment model for school-based payments and 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 implement an incremental increase to the current Urban Indian Organization (UIO) Prospective Payment System (PPS) rates effective July 1, 2021, through the duration of the Public Health Emergency (PHE).
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 revise the previously approved date for payment of retention bonuses to direct support workers pursuant to the American Rescue Plan Act (ARP) of 2021, Section 9817 (Pub. L. 117-2). Payment by agencies to staff must occur between July 1, 2021 and December 31, 2022.
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 a temporary 12% rate increases for home health aides.
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 resource disregards during the COVID-19 public Health emergency.
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 election to add nursing facility health care isolation centers (HCICs) and the accompanying payment provisions that were temporarily implemented in response to the COVID-19 PHE.
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 the state to issue a COVID-19 related direct payment program for select providers.
Summary: The purpose of this amendment is to comply with the American Rescue Plan (ARP) Act of 2021 that requires coverage of COVID-19 vaccines, testing, treatment, and treatment of a condition that could complicate the treatment of COVID-19 in Medicaid.
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 service scopes and billing processes for four 1915(i) services -- Day Services, Non-Medical Transportation, Prevocational Services, and Supported Employment Services -- to maintain a stable workforce and provider pool and preserve significantly impacted HCBS provider networks for non-residential services.
