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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: The purpose of this amendment is to amend the State Plan to assure coverage of items and services furnished in connection with a qualified clinical trial.
Summary: This SPA provides Michigan with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This SPA provides Louisiana with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
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 implement coverage and payment changes to section 1915 Connecticut Home Care Program for Elders (CHCPE) Services and section 1915(k) community first choice services consistent with the state’s ARPA section 9817 HCGS spending plan.
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 permit the District of Columbia Medicaid Program to increase reimbursement to Medicaid providers to one hundred percent (100%) of the rates paid by the Medicare program in order to support additional costs related to administration of COVID-19 vaccines during the COVID-19 public health emergency effective December 11, 2020. The SPA will also clarify that COVID-19 vaccine administration may be reimbursed to the administering provider, but not the nursing facility or intermediate care facility for individuals with intellectual disabilities (ICF/IID), where the procedure is provided to a Medicaid enrolled individual. Additionally, this SPA makes the following adjustments to benefits currently covered in the state plan: Coverage of COVID 19 vaccine administration may be furnished by pharmacies, pharmacists, pharmacy interns and pharmacy technicians within their scope of practice, who are qualified providers of COVID-19 vaccines in accordance with the PREP Act Declaration and authorizations.
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 temporarily waive of pharmacy signature requirements.
Summary: Update the PCCM program to allow individuals to change their PCP without cause, and mandates enrollment for 19 and 20-year-old individuals who are eligible under Medicaid expansion.
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 implement coverage of COVID-19 vaccine administration and COVID-19 Test administration when provided by pharmacists, pharmacy interns and pharmacy technicians, to the extent authorized by the PREP Act; and 2) Effective December 11, 2020, establish reimbursement rates for the COVID-19 vaccine administration at 100% of the Medicare rate.
