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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 proposes to bring Vermont into compliance with the 340B drug pricing program requirements in the Covered Outpatient Drug Final Rule with comment period (CMS-2345-FC).
Summary: This SPA proposes to bring Vermont into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Summary: This SPA reflects that Vermont will use MAGI-based income methodologies for purposes of determining medically needy eligibility for parents/caretaker relatives, pregnant women, and children. All resources will be disregarded for purposes of determining eligibility for these medically needy groups subject to MAGI-based income methodologies.
Summary: Updates the rates that use the Medicare Resource Based Relative Values Scale payment methodology. This SPA also implements criteria used to pay for anesthesia services.
Summary: This amendment proposes to exclude from coverage benzodiazepines for all conditions and barbiturates for the treatment of epilepsy, cancer and chronic mental health disorders for full benefit dual eligible as Medicare Part D will provide this coverage.