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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 proposes to amend the State Plan to cover prescribed drugs when medically necessary during drug shortages identified by the United States Food and Drug Administration (FDA).
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 suspend all pharmacy copays for eligibility groups consistent with 42 CFR 435 Subparts B, C, and D.
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 waive any signature requirements for the dispensing of drugs effective 3/1/2020.
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 update the drug benefits in order to make an adjustment to the professional dispensing fee when medications are delivered to an individual's residence, make exception to the the Commonwealth's preferred drug list if drug shortages occur and automatic renewal for prior authorization without clinical review.
Summary: Proposes to authorize the state to enter into state specific value or outcome-based supplemental rebate agreements with drug manufacturers for drugs provided to the Medicaid Program.
