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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: The amendment seeks to update Rhode Island’s Medicaid State Plan to provide assurance of coverage of COVID-19 vaccine administration, testing, treatment, and stand-alone vaccine counseling for children.
Summary: This SPA provides Hawaii with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This SPA provides Maryland with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This SPA authorizes coverage and reimbursement of COVID-19 vaccine and vaccine administration, in compliance with the American Rescue Plan (ARP) Act of 2021.
Summary: This SPA authorizes coverage and reimbursement of COVID-19 treatment, including treatment of a condition that could complicate treatment of COVID-19, in compliance with the American Rescue Plan (ARP) Act of 2021.
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.
