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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 update the excluded drug coverage language, as well clarify that for claims billed through the pharmacy point of sale system will be reimbursed using the reimbursement methodology found in Attachment 4.19-B for prescribed drugs.
Summary: State is increasing the rates for the following 1915(i) services: peer support, family peer support, and training and supports for unpaid caregivers. Other revisions to the state plan include modifications to the requirements of care coordinators, individual provider qualifications for the housing support service, and the quality remediation process for quality measures in the state plan.
Summary: The state adopts the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: Effective for dates of service on or after January 1, 2023, this amendment provides for an inflationary increase of 3.75 percent for nursing facility (NF) services and implements a new payment methodology for prope1iy costs.
Summary: This amendment clarifies supplemental payments referenced in Utah’s American Rescue Plan Act (ARPA) Home and Community Based Services (HCBS) Enhanced Funding Spending plan.