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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 amendment is to expand the settings an ambulance provider may transport a beneficiary to from only a nursing facility or hospital to any appropriate setting.
Summary: This amendment updates the requirements in the Medicaid State Plan for licensed mental health professionals who provide outpatient mental health services to clients eighteen years of age and younger.
Summary: Amends Delaware Title XIX State plan specifically to attest that the Delaware Medicaid Transportation program is in compliance with section 1902(a)(87) of the Social Security Act.
This SPA proposes to increase the professional dispensing fee to $15.73 for pharmacies with an annual prescription volume between 0 and 39,999 prescriptions; $13.62 for pharmacies with an annual prescription volume between 40,000 and 69,999; or $11.52 for pharmacies with an annual prescription volume greater than or equal to 70,000.
Summary: Proposes to add Licensed Psychologist to the provider qualification under Other Licensed Practitioners (OLP) by agencies designated under the Child and Family Treatment and Support Services (CFTSS) designation process.
Summary: This amendment is to add two additional provider types, Licensed Dietician, and Licensed Genetic Counselor, to the Other Licensed Practitioner section of the State Plan.