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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: To establish Certified Community Behavioral Health Clinics (CCBHCs) in West Virginia. CCBHCs offer a package of behavioral health and substance use disorder (SUD) se1vices and support.
Summary: This amendment grants authority to the appointed Executive Director to submit state plans on behalf of the Division of Medicaid, Office of the Governor, the single state agency.
Summary: This amendment is to conduct Medicaid presumptive eligibility (PE) determinations. PE groups: children under age 19, parents and other caretaker relatives, pregnant women, adults, and former foster care children, the effective date is May 12, 2023. PE for individuals needing treatment for breast or cervical cancer, the effective date is January 1, 2023.
Summary: This amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This amendment allows the Division of Medicaid to reimburse certain diabetic equipment and supplies based on reimbursement methodology for drugs when provided through the pharmacy venue.
Summary: This amendment allows Mississippi to cover prescribed drugs that are not covered outpatient drugs (including drugs authorized for import by the Food and Drug Administration) when medically necessary during drug shortages.
