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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 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 West Virginia with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
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 suspend the requirement for ambulance providers to transport beneficiaries to the nearest appropriate medical facility and to suspend the requirement for beneficiaries to be stretcher bound to use non-emergency ambulance services, to ensure that ambulance services and service destinations are not restricted during the public health emergency period.
Summary: Effective January 1, 2021, this amendment adds a $1,000 per calendar year dental benefit for adults receiving Medicaid benefits through an Alternative Benefit Plan.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. This state plan amendment provides coverage of the administration of COVID-19 vaccines upon Emergency Use Authorization or approval from the Food and Drug Administration. This state plan amendment also increases reimbursement for COVID-19 vaccine administration based on the Medicare prevailing rate.
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 make changes to eligibility, suspend most cost-sharing, adjust some existing benefits, expand telehealth flexibilities, and make certain payment changes.
Summary: This SPA proposes to align the physical therapy and occupational therapy benefits under the Alternative Benefit Plan (ABP) with the standards for those benefits in the
regular Medicaid State Plan that were recently approved by CMS under [TN]WV-19-0002. As part of our review of SPA [TN]WV-19-0003, we conducted a review of all individual Alternative Benefit Plan (ABP) templates in the West Virginia State Plan, consistent with CMS policy.
