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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 SPA proposes to add prior authorization information on preferred and non-preferred drugs, as well as for High-Investment Carve-Out drugs when delivered in the inpatient setting.
Summary: This amendment expands school-based health services (SBHS) under the Rehab benefit with the following services: 1) school health aide service; 2) developmental rehabilitative therapy (enhances existing service); 3) specialized transportation. The SPA also introduces a new reimbursement methodology for SBHS.
Summary: This amendment was submitted in order to update the fee schedules across all non-institutional benefit categories utilizing Medicare's annual update.
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to waive the signature requirements for prescription drugs during the COVID Public Health Emergency from 3/1/20 through 9/1/22.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend the suspension of premiums for the state's Work Incentives group under section 1902(a)(10)A)(ii)(XIII) of the Act.
Summary: This amendment provides coverage of COVID-19 prevention and treatment as benefits in Texas Medicaid, including coverage for conditions that may seriously complicate COVID-19 treatment.
Summary: This State Plan Amendment, the state is incorporating changes that were implemented during the COVID-19 Public Health Emergency, such as adding new services, adding incentive payments for paid internships, allowing specific services the option of self-direction, and allowing specific services to be provided via telehealth.