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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 update language and the reimbursement methodology for 340B Antihemophilic Factor products and Physician Administered Drugs.
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 signature requirements related to dispensing of drugs during the COVID-19 public health emergency.
Summary: This amendment proposes to add four types of clinicians to the providers qualified to provide core services in Federally Qualified Health Centers: licensed certified social workers, licensed professional counselors, licensed mental health counselors, and licensed marriage and family therapists.
Summary: Effective August 1, 2021, this amendment corrects an error regarding the required frequency of contacts between targeted case managers and beneficiaries.
Summary: This amendment proposes to add a new section for Medication Assisted Treatment (MAT) based on guidance in CMS’s State Health Official Letter #20005, dated December 30, 2020.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend cost-sharing for all eligibility groups for COVID-19 testing and treatment, add new optional benefits (management and evaluation service for adults with SMI; well-check service for children and adults with developmental disabilities); adjust benefits currently in the state plan (exempt certain services from annual limits when associated with testing or treatment of COVID-19); allow 90-day supplies of drugs and early refills; allow exceptions to the State's preferred drug list in case of shortages; establish payments for the new optional benefits; increase rates for direct care services and day habilitation; establish payments for delivering existing services through telehealth; and establish rates for COVID-19 screening and testing.
Summary: This SPA is to comply the Medicaid Drug Utilization Review (DUR) provisions
included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271). State is claiming -0- fiscal impact for 2020 and 2021.
