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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: Includes Barbiturates "Used in the Treatment of Epilepsy, Cancer, or a Chronic Mental Health Disorder" and Benzodiazepines in Part D Drug Coverage.
Summary: To include barbiturates used in the treatment of epilepsy, cancer, or a chronic mental health disorder, and benzodiazepines in Part D drug coverage.
Summary: Excludes from coverage benzodiazepines for all conditions and barbiturates for the treatment of epilepsy, cancer and chronic mental health disorders for full benefit dual eligibles as Medicare Part D will provide this coverage.
Summary: Changes the definition of usual and customary, decrease the dispensing fee from $4 to $2 for non-compounded drugs and from $5 to $3 for compounded drugs.