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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.
Updates Outpatient Hospital Services payment information by removing references to Outpatient Hospital Rates as a payment method under Outpatient Prospective Payment System (OPPS). This method is outdated and no longer used.
Amended the Community First Choice (CFC) program to add an option that allows level of care assessments to be completed remotely when an in-person visit is not possible and also adds language that allows participants and providers to finalize the person-centered plan with an electronic signature, including voice signature.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to gradually decrease the enhanced supplemental payments during the period of April 1, 2023, through December 31, 2023 for Inpatient & Outpatient Supplemental Payments Post-PHE Unwind (Safety Net Assessment Fund).
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to gradually decrease the enhanced supplemental payments during the period of April 1, 2023, through December 31, 2023 for supplemental payments for Small Rural Disproportionate Share Hospitals.
Summary: This amendment will add language back to the Medicaid State Plan to clarify the state covers and reimburses all United States Preventive Services Task Force (USPSTF) grade A and B preventive services and approved vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
This amendment reflects the appointment of Dr. Charissa Fotinos as the state’s Medicaid Director, in the Washington State Health Care Authority, which is the single state agency.
Summary: This amendment is to cover and reimburse for Dental Health Aide Therapists (DHAT) in accordance with state Senate Bill 5079 (codified in state law at RCW 70.350.020), signed into law on February 22, 2017.