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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 proposes to assure the American Rescue Plan Act’s (ARP) mandatory coverage of the COVID-19 vaccine, testing, and treatment without cost sharing.
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 Oklahoma with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
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: Provides assurances regarding the state's compliance with federal medical transportation requirements found under the Consolidated Appropriations Act, 2021.
Summary: Revises the language describing the methodology used to calculate the capitation rate payment for PACE organizations. The SPA will remove the Medicare Economic Index ( MEI) adjustment from the rate methodology, as the PACE capitation rate is based on the amount that would otherwise be paid (AWOP) which is reviewed annually and adjusted as needed, without regard to the MEI.
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 establish coverage and reimbursement for all FDA authorized self-collected COVID-19 tests inclusive of those requiring laboratory processing.