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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 provides Washington with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This amendment is to clarify the Department of Health Care Services’ third-party liability practices for prenatal services and child support enforcement services. It also amends exceptions for recovery practices and updates Medicare thresholds.
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 provide temporary rate increases for providers (Adult day health, day habilitation, adult foster care, children's behavioral health initiative, private duty nursing (continuous skilled nursing), durable medical equipment, home health, personal care attendants) in accordance with Massachusetts' approved Initial Spending Plan for home and community based services under the American Rescue Plan Act of 2021.
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 mechanism to make provider payments to be used for workforce investment for direct care HCBS workers and is a component of New Hampshire's HCBS Spending Plan.
Summary: This SPA attests to the state’s coverage of COVID-19 vaccines and administration of vaccines, as required by section 1905(a)(4)(E) of the the Social Security Act. CMS supports this change, as it is required by statute.
Summary: Updates the State Plan language regarding the Community First Choice program to replace references to the attendant care and the LTSS tracking System with personal assistance services and data management.
Summary: Removes citizenship, national status, and immigration status as edibility requirements for any PE program, including hospital PE. It also allows additional provider types to serve as qualified entities to make PE determinations for the Adult Group, Parent/Caretaker Relatives, Former Foster Care Youth, Children, and Pregnant Women.
Summary: Effective October 1, 2021 this amendment removes federally optional liens and recoveries. This amendment updates third-party liability section to reflect current law and practice with respect to the BBA of 2018 and it removes the language regarding the cost effectiveness premium purchase program for group health insurance that is authorized under section 1906 of the SSA.