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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: In this time-limited state plan to respond to the COVID-19 national emergency, AZ has elected to temporarily: Expand eligibility to cover COVID-19 testing for uninsured individuals; Streamline enrollment for children whose family income changes during the disaster period; Suspend all cost sharing and premiums; and Expand access to covered outpatient drugs through adjustments to prior authorization and exceptions to the preferred drug list in the event of a drug shortage.
Summary: Updates the payment for professional services in case of a governor-declared state emergency (such as the current COVID-19 outbreak), when the Medicaid agency determines it is appropriate. This SPA also ensures payment for professional services provided via telephone services and /or online digital evaluation and management services at the same rates as for professional services provided face-to-face or via telemedicine, to support the delivery of health care services during a state of emergency.
Summary: Addresses supplemental payments for transportation services in case of a governor-declared state emergency (such as the current COVID-19 outbreak), when the Medicaid agency determines it is appropriate
Summary: Amendment extends services to pregnant women to implement tobacco cessation and as directed by CMS removes outdated references to the Louisiana Health Assessment Referral and Treatment (LaHART) program.
Summary: Updates Services for Individuals Age 65 or Older in IMDs and Inpatient Psychiatric Facility Services for Individuals Under 22 Years of Age in order to align certain timeframes related to prior authorization.
Summary: revise the Behavioral Health rehabilitation and include a level of care for Intensive In-Home Behavioral Health Services as a part of Oregon’s services for children’s behavioral health.
Summary: amends provisions governing the Pharmacy Benefits Management program in order to allow the state to pursue out-comes based agreements with manufacturers and to align the provisions with the current Medicaid State plan.
Summary: Revises North Carolina’s End State Renal Disease (ESRD) program’s policies and titles to expand dialysis to patients diagnosed with Acute Kidney Injuries (AKI).
