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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 provides authority to cover and to reimburse for Psychiatric Residential Treatment Facility (PRTF) services for eligible Michigan Medicaid beneficiaries.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to provide a temporary extension to specific COVID-19 disaster relief provisions for specific clinic specimen collection and clinic vaccine administration payments currently authorized in DR SPAs 20-0009 and 21-0011.
Summary: This amendment proposes a change to the prior authorization requirements for non-routine therapy services provided to beneficiaries residing in nursing facilities.
Summary: The purpose of this amendment is to comply with the requirements for mandatory coverage of COVID-19 vaccines, testing, and treatment without cost-sharing under section 9811 of the American Rescue Plan.
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 administration of COVID-19 therapies and treatments by licensed paramedics within the scope of their practice as defined under State law.
Summary: This SPA provides authority to address the National Emergency by including mandatory coverage of COVID-19- related testing and treatment services in compliance with Sections 9811 and 9821 of the American Rescue Plan of 2021.
Summary: This SPA provides the District of Columbia with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This SPA provides Michigan 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 is to permit the District of Columbia Medicaid Program to increase reimbursement to Medicaid providers to one hundred percent (100%) of the rates paid by the Medicare program in order to support additional costs related to administration of COVID-19 vaccines during the COVID-19 public health emergency effective December 11, 2020. The SPA will also clarify that COVID-19 vaccine administration may be reimbursed to the administering provider, but not the nursing facility or intermediate care facility for individuals with intellectual disabilities (ICF/IID), where the procedure is provided to a Medicaid enrolled individual. Additionally, this SPA makes the following adjustments to benefits currently covered in the state plan: Coverage of COVID 19 vaccine administration may be furnished by pharmacies, pharmacists, pharmacy interns and pharmacy technicians within their scope of practice, who are qualified providers of COVID-19 vaccines in accordance with the PREP Act Declaration and authorizations.
