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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 plan amendment updates rates for dental services, Durable Medical Equipment (DME) products, rehabilitation services, and Early Periodic Screening, and Diagnosis and Treatment (EPSDT).
Summary: This plan amendment revises the reimbursement methodologies for Psychiatric Residential Treatment Facilities (PRTF) and hospital supplement payments for freestanding children's hospitals with greater than fifty percent Medicaid utilization.
Summary: This plan amendment removes obsolete language increasing the nursing facility per diem rate by $6.13 per day. That increase has now been absorbed into the standard per diem methodology and rates.
Summary: This amendment provides reimbursement for services provided by licensed pharmacists, and pharmacy interns and pharmacy technicians supervised by phamacists, who are acting within their scope of practice or in a collaborative agreement with a provider licensed in Virginia or are specified in Board of Pharmacy protocols for licensure that have been reviewed and accepted by the Department of Medical Assistance Services and are services covered by Medicaid.
