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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 attests to the state’s coverage of COVID-19 vaccines and vaccine administration, COVID-19 testing, and COVID-19 treatment, as required by sections 1905(a)(4)(E) and 1905(a)(4)(F) of the Social Security Act (Act).
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 to respond to the COVID-19 national emergency. The purpose of this amendment is to expand telehealth, allow 90-day refills and expand prior authorization for medications, nursing home rate increase, reimbursements to certain providers for COVID-19 related expenses; increase therapeutic leave for individuals with IID/IDD living in ICFs, and waive automatic discharge from ICF after 30 hospital stay days.
Summary: Technical changes to the Child Mental Health Wraparound HCBS state plan benefit to correct errors in pagination resulting from the approved SPA TN 19-007. This SPA makes revisions to the qualification requirements for staff making level of need determinations to allow for the inclusion of experience in areas closely related to wraparound services to count towards an individual’s experience, in addition to clinical experience.
Summary: Revises Medicaid reimbursement rates for medical equipment, medical supplies, and vision supplies and reestablishes the state's previous reimbursement methodology on a time-limited basis.
Summary: Reimbursement for medical equipment and medical supplies into compliance with the 21st Century Cures Act of 2016 and State Medicaid Director letter 18-001.
Summary: Renews the AMHH §1915(i) home and community-based State Plan benefit and the renewal of the §1915(b)(4) waiver that allows for selective contracting of providers for AMHH and BPHC services, specifically Community Mental Health Centers to provide the services.
Summary: This state plan amendment outlines the alternative benefit plans for Healthy Indiana Plan Basic and adds enhanced substance use disorder benefits.
