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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add pharmacists, pharmacy technicians, pharmacy interns and pharmacies as qualified providers for COVID-19 vaccine administration. It also establishes reimbursement of swing beds in Critical Access Hospitals at a rate of $400/day and adopts the Medicare fee schedule for COVID-19 vaccine administration reimbursement.
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 modify the other licensed practitioner benefit to allow licensed pharmacists within their state scope of practice with CLIA waiver certification to provide diagnostic COVID-19 antigen tests; and to reimburse pharmacists providing COVID testing using a state-developed fee schedule for diagnostic testing.
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 change the end date of some of the provisions approved in Arkansas' previously approved disaster relief state plan amendment (SPA 20-0015). It changes the end date of the Well Check services and the Day Habilitation Enhanced Payments to the end date of the national public health emergency. The other provisions of the previously approved disaster relief SPA are unchanged.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend cost-sharing for all eligibility groups for COVID-19 testing and treatment, add new optional benefits (management and evaluation service for adults with SMI; well-check service for children and adults with developmental disabilities); adjust benefits currently in the state plan (exempt certain services from annual limits when associated with testing or treatment of COVID-19); allow 90-day supplies of drugs and early refills; allow exceptions to the State's preferred drug list in case of shortages; establish payments for the new optional benefits; increase rates for direct care services and day habilitation; establish payments for delivering existing services through telehealth; and establish rates for COVID-19 screening and testing.
Summary: This amendment was submitted in accordance with Section 214 of the Children's Health Insurance Program Reauthorization Act (CHIPRA), which permits States to cover certain children and pregnant women in both Medicaid and the Children's Health Insurance Program (CHIP) who are "lawfully residing in the United States" as described in section 1903(v)(4) and 2107(e)(l)(J) of the Social Security Act (the Act). Approval of this option resulted in a Federal budget impact of $1,546,729.00 for Federal Fiscal Year (FFY) 2018 and $4,891,174.00 for FFY 2019.
Summary: This amendment was submitted to establish a limit on the weekly amount of Medicaid funded speech therapy, occupational therapy, and physical therapy that are available to eligible beneficiaries, and to allow for extensions based on medical necessity.