An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: SPA was submitted to request a waiver of the regulatory requirement at 42 CFR 455, Subpart F to enter into a contract with a Medicaid Recovery AuditContractor (RAC) vendor to identify overpayments and underpayments and to recoup overpayments.
Summary: This SPA seeks an exception to 42 CFR § 455.502, which requires each state to establish a Recovery Audit Contractor (RAC) program. The state seeks this exception because it is unable to procure a RAC vendor due to the small fee-for-service claims volume in the state.
Summary: Separates and differentiates between services provided in a school setting under EPSDT versus those school-based services provided pursuant to an Individual Education Plan (IEP).
Summary: Updates the scope of the state's pharmacist-covered services in order to align with Iowa's new protocols for (1) pharmacists ordering and dispensing naloxone and nicotine replacement therapy tobacco cessation products, and (2) pharmacists ordering and administering vaccines.
Summary: Removes the state’s 1915(l) option from the state plan, as Idaho is transitioning coverage of substance use disorder (SUD) treatment in institutions of mental disease from the state plan to the state’s SUD section 1115(a) demonstration, known as Idaho Behavioral Health Transformation
Summary: Updates the clinical laboratory services page of the State Plan as a result of the 2020 calendar year fee review of clinical diagnostic laboratory services
