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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: Provides a Process Under Which the State Seeks Advice from Designees of Indian Health Programs and Urban Indian Organizations on State Plan Amendments, Waivers, and Proposal for Demonstration Projects that may Affect Indian Health, Indians, or Urban Indian Organizations.
Summary: Allows licensed pharmacists employed by an AHCCCS-registered pharmacy and acting within their scope of practice to administer seasonal flu and pneumococcal vaccines and anaphylaxis agents. AHCCCS-registered pharmacies will be reimbursed an administration fee for seasonal flu and pneumococcal vaccines and anaphylaxis agents administered by licensed pharmacists.
Summary: Implements Section 5006 e of the Recovery Act, which mandates that States consult withTribes and designees of Indian health programs on State plan amendments, waiver requests, or proposals for a demonstration project that are likely to have a direct effect on Indians.
Summary: Clarifies reimbursement methodology for the payment of the administration of the influenza vaccine, and to provide the reimbursement methodology for the cost of the influenza vaccine for Medicaid recipients when administered gby pharmacists.
Summary: Eliminates the coverage of legend vitamins and mineral products, except prenatal vitamins and fluoride, which will continue to be covered for Medicaid eligible recipients.
Summary: This SPA transmitted a proposed amendment to your Agency's approved Title XIX State plan to modify the Vermont Drug Utilization Review (DUR) Board's membership requirements, duties, and responsibilities.
Summary: This amendment revises the State's reimbursement methodology for setting payment rates for hospital services. Specifically, it will amend the plan language to revise inconsistent and ambiguous language and correct examples of the rate setting methodologies.