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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 state plan amendment will allow Medicaid to move the authority for the per member per month enhanced management fees for primary care providers participating in the Carolina Access program from the Primary Care Case Management section of the state plan to the physician reimbursement section of the Medicaid State Plan.
Summary: This amendment looks to implement updates to physician, medical clinic, DME/MEDS fee schedules, increase rates for Etonogestrel implant system LARC devices, add a code for monkeypox testing to select fee schedules, and update DME/MEDS fee schedule. This SPA also removes age limits for naturopath coverage and expands coverage for behavioral health clinicians to include associate practitioners.
Summary: This amendment proposes a change to the prior authorization requirements for non-routine therapy services provided to beneficiaries residing in nursing facilities.
Summary: This amendment proposes to comply with Electronic Visit Verification System (EVV) requirements by January 1, 2023, in accordance with Section 12006 of the 21st Century CURES Act.
Summary: The State adopts the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This SPA implements policies and procedures to coincide with the merger of the Utah Department of Health and the Utah Department or Human Services, effective July 1, 2022. The new name of single state agency is the Utah Department of Health and Human Services.
Summary: disregard two sources of income/resources: 1) any refundable credit against taxes made pursuant to Vermont's child tax credit or pursuant to a similar tax credit enacted by the State and intended by legislation to not be considered as countable income or resources for benefit programs; and 2) any wages that are made pursuant to Vermont's Premium Pay for Workforce Recruitment and Retention Program or a similar workforce recruitment and retention program enacted in Vermont and intended by the legislature to not be considered as countable income or resources in determining eligibility for benefit programs.
