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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 amendment updates Physician Assistant Services, Screening, Brief Intervention, Referral and Treatment Services Providers, and Collaborative Care Services Providers to the Medicaid State Plan.
Summary: This amendment adds coverage for the human papillomavirus (HPV) vaccine for persons 46 years of age or older who meet certain medical criteria.
Summary: This amendment seeks to modify the reimbursement rates for community behavioral health services, add community health workers to the list of acceptable practitioners, and update the accreditation language.
Summary: This amendment allows physician assistants to prescribe physical therapy, occupational therapy, and services for speech, hearing, and language disorders in the clinic, with both physician assistants and advanced practice registered nurses being able to prescribe these in the home setting.
Summary: This amendment will allow Medicaid to exempt the following drugs from Medicaid co-payments: Opioid Antagonists, Nicotine Replacement Therapy, and medications used to treat opioid use disorder.
Summary: This amendment proposes to add the requirement for Tier 2 and Tier 3 PCPlus practices to ensure the provision of community based Community Health Worker (CHW) services. It also includes minor methodological and operational updates.
Summary: Recognizes the shift to require managed care plans to cover transportation to all Medicaid-covered services, clarifies coverage language, and reflects other technical adjustments.
