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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 time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow 12 months continuous eligibility for children under age 19, waive cost sharing for testing services, modify the enforcement of premium and spendown obligations during the emergency period for certain populations, and allow exceptions to the preferred drug list if shortages occur.
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: Proposes to authorize the state to enter outcome-based supplemental rebate agreements with drug manufacturers for drugs provided to the Medicaid program
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, suspend the resource test in determining eligibility for certain eligibility groups, add presumptive eligibility (PE) for certain eligibility groups, suspend premiums for certain individuals, expand telehealth, extend all prior authorization for medications by automatic renewal without clinical review or time/quantity extensions, allow the state to make exceptions to its published Preferred Drug List if drug shortages occur, and increase certain payment rates.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow cover the new optional group for COVID testing; apply less strict resource and income methods when determining eligibility for certain individuals; consider individuals evacuated from the state due to the emergency to continue to be residents; provide medical coverage to non-residents who are quarantined in the state due to COVID-19; allow hospitals to make presumptive eligibility decisions for certain individuals; suspend enrollment fees and premiums for all individuals; expand telehealth; add certain benefits and increase some payment rates related to the COVID-19 national emergency.
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 cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
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 cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to suspend premiums for the Employed Individuals with Disabilities program eligibility group, make adjustments to prior authorization and the day supply or quantity limit for covered outpatient drugs, suspend the Qualified Service Provider qualifications regarding competency and state criteria, waive the timelines for nursing facility rate reconsiderations and appeals, and waive the 15 day limit for payment for a reserved bed for an inpatient hospitalization.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to expand eligibility to cover COVID-19 testing for uninsured individuals, make other eligibility and enrollment changes, suspend premiums for the Employed Individuals with Disabilities program eligibility group, automatically renew prior authorization for medications, and adjust post eligibility treatment of income
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. In this amendment Minnesota elects to (1) waive cost sharing for COVID-19 testing and treatment, (2) suspend disenrollment due to failure to pay premiums for working disabled BBA group, (3) expand telehealth, and (4) to allow for 90-day refills without prior authorization for certain maintenance drugs.
