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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 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: 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 will allow the District to provide assurance of compliance with mandatory annual My Health GPS Health Home reporting of the Core Set of Children's Health Care Quality Measures and the behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid.
Summary: This amendment will allow the District to provide assurance of compliance with mandatory annual state reporting of the My DC Health Home's Core Set of Children's Health Care Quality Measures and the behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid.
Summary: Adds Licensed Behavior Analysts (LBAs) to the definition of a "Credentialed Addiction Treatment Professional." It recognizes them as a provider type under the Addiction and Recove1y Treatment Services (ARTS) program.
Summary: To implement a new state-based exchange (SBE). Functions previously handled by the Federally Facilitated Marketplace will be moved to Virginia's SBE.
Summary: Allows Dual Special Needs Plans to contract to furnish previously approved ADHP services under the provisions of §1915(a)(l ), which serves all geographic areas in the District, through capitated monthly payments made to the health plan.
Summary: Permits the District of Columbia to comply with the third-party liability requirements authorized under the Bipartisan Budget Act (BBA) of 2018 (Pub. L. 115- 123) and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019 (Pub. L. 116-16), affecting the BBA of 2013.
