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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 discontinue coverage of legend (prescription only) brand and generic agents used for symptomatic relief of cough and cold. The Agency will continue to cover certain over-the-counter (OTC) cough and cold products in an effort to provide cost effective alternatives to recipients.
Summary: The plan amendment clarifies the orthotic and prosthetic services available under Early and Periodic Screening, Diagnosis and Treatment (EPSDT) recipients under the age of 21. The amendment change does not have a direct impact on Indians, Indian Health programs, or Urban Indian Organizations.
Summary: Which provides for smoking cessation program services covered for all participants who smoke when prescribed by a physician or health care professional with prescribing authority including smoking cessation products with behavioral intervention services provided by a wide range of healthcare provider specialties.
Summary: This SPA establishes a fee schedule for freestanding birth center services provided on or after April 1, 2012. West Virginia submitted this amendment to comply with Section 2301 of the Affordable Care Act that amends Section 1902(a) of the Social Security Act which includes limited coverage and payment of services to Medicaid members by freestanding birthing center providers. Additionally, this SPA indicates that physicians, midwives, and other licensed practitioners are paid a separate fee for services performed in the freestanding birth center based on a procedure code.
