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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: Effective January 1, 2021, this amendment updates the State Supplementary Payment levels for the "Optional State Supplement Beneficiaries" eligibility group.
Summary: update the benchmark plan for the ABP for the New Adult Group. This is being updated to a 2014 base benchmark plan pursuant to 45 CFR §156.110. The ABP delivery model summary is also being updated based on the approved 1115 Global Commitment to Health waiver. This SPA was approved June 10, 2021 with an effective date of January 1, 2017.
Summary: Effective January 1, 2021, this amendment expands the provider types that can authorize home health plans of care and order durable medical equipment.
Summary: This amendment was submitted in order to clarify the existing clinic services benefit and to add a $1,000 per calendar year dental benefit for adults.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. This state plan amendment provides coverage of the administration of COVID-19 vaccines upon Emergency Use Authorization or approval from the Food and Drug Administration. This state plan amendment also increases reimbursement for COVID-19 vaccine administration based on the Medicare prevailing rate.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase payment rates for durable medical equipment, dental services, ambulance services, physical therapy, occupational therapy, speech therapy, intermediate care facilities, and personal care services. The payment increases are effective from July 1, 2020 through December 31, 2020.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to begin reimbursing enrolled Hospitals and Critical Access Hospitals for the use of Medicare certified swing beds and to adjust certain inpatient rates to allow for increased reimbursements.
Summary: This SPA permits licensed pharmacists to enroll in the Vermont Medicaid program, allowing coverage of COVID-19 diagnostic testing and specimen collection by licensed pharmacists to the extent permitted by state and federal law.
