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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 modifies the language provisions for coverage of weight loss drugs as outlined on the Wisconsin Medicaid Drug Search Tool found on the state’s website.
Summary: This amendment for Tailored Care Management is to increase the Health Home payment rate for higher acuity beneficiaries and to provide assurances of mandatory Core Set measures.
Summary: This amendment will add one (1) encounter eligible visit per IHS-eligible Medicaid beneficiary per day to the currently allowed five (5) encounters per day.
Summary: Move authority for the Tribal Health Improvement Program (T-HIP) from a 1915(b) waiver to a 1932(a) SPA, while further aligning the program design with primary care case management entity requirements found in 42 CFR § 438.2.
Summary: This amendment updates language for excluded drugs covered by SCDHHS including weight loss medicine, prescription vitamins & minerals and OTC drugs.
Summary: This amendment is to include the new adult group in Eastern Band of Cherokee Indians (EBCI) Tribal Option primary care case management entity (PCCMe) program eligibility.
Summary: This amendment proposes to allow the remote delivery of Crisis Services for Individuals with Intellectual and/or Developmental Disabilities (CSIDD) through telephonic or other technology in accordance with State, Federal, and Health Insurance Portability and Accountability Act (HIPAA) requirements. Other technology means any two way, real-time communication technology that meets HIPAA requirements.
