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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: Will permit the District of Columbia’s Medicaid Program to increase the personal needs allowance standard for eligible institutionalized long-term care residents and set annual increases tied to the federal Cost-Of-Living adjustment (COLA) published by the Social Security Administration.
Summary: Description: Proposes to permit the District of Columbia Medicaid program to effectuate the coverage of doula services, effective October 1, 2022.
Summary: To add coverage to the District of Columbia’s Alternative Benefit Plan Medicaid Expansion, Routine Patient Cost in Qualifying Clinical Trials.
Summary: To effectuate the coverage of routine patient costs incurred during qualified clinical trials from January 1, 2022 forward, as required by the Consolidated Appropriations Act, 2021, Division CC, Title II, Section 210.
Summary: To allow the District to transition its Section 1115 Behavioral Health Transformation Demonstration Program services to permanent State Plan authority in order to retain authority to provide Medicaid reimbursement.
Summary: This amendment provides assurances to comply with federal non-emergency medical transportation requirements, as directed by CMCS in July 12, 2021, CMCS Information Bulletin.
Summary: This amendment proposes to permit the District to enroll additional licensed providers (psychologists, licensed independent clinical social workers, licensed professional counselors and licensed marriage and family therapists) to service the District’s Behavioral Health population.
