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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: Allows the Division of Medicaid (DOM) to reimburse for psychiatric therapeutic procedures that are billed using Current Procedural Terminology (CPT) codes at ninety percent (90%) of the Medicare fee schedule in effect on January 1, 2022 and as may be adjusted each July thereafter.
Summary: Allows family planning services to be reimbursed ninety percent (90%) of the Medicare fee schedule in effect January 1, 2022 and as may be adjusted each July thereafter.
Summary: Allows the Division of Medicaid (DOM) to reimburse for therapy services at ninety percent (90%) of the Medicare rate in effect on January 1, 2022. and as may be adjusted each July thereafter.
Summary: The purpose of this SPA is to demonstrate compliance with the American Rescue Plan Act provisions that require states to cover COVID-19 testing consistent with the Centers for Disease Control and Prevention (CDC) definitions of diagnostic and screening testing for COVID-19.
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 increase payments for nursing facilities and to allow supplemental payment to all Nursing Facilities during the COVID-19 state of 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 allow for a temporary change to the nursing facility rate setting methodology.
Summary: To update Delaware State Plan to bring the state in compliance with the Third-Party Liability Requirements under the Bipartisan Budget Act (BBA) of 2018 and Medicaid Services Investment and Accountability Act (MSIAA) of 2019 practices.