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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 South Dakota with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: The purpose of this SPA is to add mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Summary: This SPA provides mandatory coverage for COVID-19 vaccines and vaccine administration, COVID-19 testing, and COVID-19 treatment including specialized equipment and therapies during the period through the last day of the first calendar quarter that begins one year after the last day of the public health emergency period.
Summary: This SPA provides Connecticut with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This time limited disaster relief SPA seeks to update the effective dates, scope, and details consistent with the state's ARPA sec. 9817 HCBS spending plan, by implementing coverage and payment changes to section 1915. Connecticut Home Care Program for Elders (CHCPE) services.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement coverage and payment changes to section 1915 Connecticut Home Care Program for Elders (CHCPE) Services and section 1915(k) community first choice services consistent with the state’s ARPA section 9817 HCGS spending plan.
Summary: Updates the Alternative Benefit Plan (ABP) State Plan to include the CHESS program approved in SPA 21-0001 which improve housing stability and health outcomes for a targeted set of Medicaid members who meet specified needs-based criteria, including individuals who have complex health conditions, have experienced homelessness, and have been determined to be likely to benefit from targeted tenancy sustaining services based on risk factors.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to (1) effective December 11, 2020, this SPA: (A) implements coverage of COVID-19 vaccine administration when provided by pharmacists, pharmacy interns, and pharmacy technicians, to the extent authorized pursuant to the PREP Act and (B) establishes reimbursement for COVID-19 vaccine administration at 100% of the Medicare rate for the pharmacy providers referenced above and on the applicable fee schedules (physician, home health agency, hospice, medical clinic, dialysis clinic, and family planning clinic); (2) effective from January 1, 2021 through February 28, 2021, implements a 2% rate increase for chronic disease hospitals; (3) effective from January 1, 2021 through February 28, 2021, implements a 5% rate increase for nursing homes and effective from March 1, 2021 through March 31, 2021, implements a 10% rate increase for nursing homes; and (4) clarifying language effective March 1, 2020 that (A) the coverage flexibility for laboratory services under 42 CFR 440.30(d) does not include self-collected COVID-19 tests for home use and (B) each laboratory testing code is priced at 100% of the applicable Medicare rate that is in effect on the date of service.
