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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 amends the State Plan to allow the State to enter into value-based contract arrangements with drug manufacturers through supplemental rebate agreements.
Summary: This SPA updates language on the Delaware excluded drug coverage pages to reflect coverage of selective medications by referencing the state’s webpage and policy handbook resources instead of listing specific covered medications. Additionally, the SPA amends the Title XIX Medicaid State Plan regarding physician administered drug reimbursement rates.
Summary: This amendment is that the state will cover all preventive services assigned a grade of A or B by the U.S. Preventive Services Task Force (USPSTF), and all approved vaccines recommended by the Advisory Committee on Immunization Practices (ACIP), and their administration.
Summary: This amendment proposes to remove the optional service, case management of high-risk pregnant women, from the Delaware Medicaid State Plan as these services will now be provided via an evidence-based home visiting model under 1115 waiver authority, effective January 1, 2023.
Summary: This amendment is to remove the High Fidelity Wrap-a-round (HFW) language from the Health Home SPA since it will now be a part of a new 1115 to prevent duplication of services.
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 end coverage for the COVID-19 testing group at 1902(a)(10)(A)(ii)(XXIII) of the Act as described in New Mexico Disaster SPA 20-0007.
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 align the resumption of premiums with the end of the unwinding period and to assign dates to the temporarily extended suspension of member copays and premiums.
