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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 SPA provides mandatory coverage for COVID-19 vaccines and vaccine administration, COVID-19 testing, and COVID-19 treatment including specialized equipment and therapies during the period through the last day of the first calendar quarter that begins one year after the last day of the public health emergency period.
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 reimbursement and coverage for swing beds in Critical Access Hospitals in AR-20-0024.
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 updates to the definition of a visit to include telehealth services in Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal Health programs and rescinds the addition of associate marriage and family therapist (AMFT) and associate clinic social workers (ASW) in FQHCs and RHCs that were originally approved under CA Disaster Relief SPA 20-0024 on May 12, 2020.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend for one year the following disaster relief flexibilities: targeted case management, telehealth, drug benefit, and behavioral health home requirements.
Summary: Pregnant Woman Proxy Payment Methodology-state plan amendment is needed to describe the payment methodology for Hawaii selection in SPA 22-0008 to extend medicaid coverage post-pregnancy from 60 days to 12 months.
Summary: This SPA provides Oklahoma with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This amendment proposes to include cost sharing for New Hampshire's comprehensive adult dental benefit for all Medicaid eligible adults age 21 and older beginning on April 1, 2023.