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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 (SPA) to respond to the COVID-19 national emergency. This state plan amendment provides coverage of the administration of COVID-19 vaccines upon Emergency Use Authorization or approval from the Food and Drug Administration. This state plan amendment also increases reimbursement for COVID-19 vaccine administration based on the Medicare prevailing rate.
Summary: Effective March 1, 2021, this amendment clarifies access to Long-Term Care Community Nursing (LTCCN) services in all appropriate settings; removes the prohibition of using Physical Therapists and Occupational Therapists; increases the approval limit for Electronic Devices from $500 to $1,200; and, updates the Group Care Homes for Children (GCH) rate methodology.
Summary: Effective January 1, 2021, this amendment adjusts the dental benefit to include crowns and certain endodontic services including root canals and apicoectomies as covered services for beneficiaries 21 years and older.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow the state to implement flexibilities for Idaho's 1915(i) State Plan HCBS Benefit for Adults with Developmental Disabilities.
Summary: Effective August 1, 2021 and expiring on July 31, 2026, this amendment renews Ohio's 1915(i) State Plan Home and Community Based Services (HCBS) benefit, specialized recovery services program.
Summary: Effective April 1, 2020, this amendment proposes to provide Medicaid coverage of durable medical equipment to support beneficiaries' mobility-related activities of daily living.
Summary: Effective August 19, 2020 this amendment adds coverage and reimbursement for three evidence-based parenting programs for children with disruptive behavior disorders.
Summary: This is a time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add the COVID-19 vaccine to the Medicaid State Plan.
Summary: Effective January 27, 2021, this amendment brings the state into compliance with a court order that instructs the state to cover medically necessary Applied Behavior Analysis (ABA) therapy to treat Autism Spectrum Disorder (ASD) for Medicaid Managed Care Organization (MCO) clients over the age of twenty and removes the limitation for managed care and fee-for-service enrollees in the Applied Behavior Analysis (ABA) therapy to treat Autism Spectrum Disorder (ASD.)
