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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 exempts general acute care, reimbursed under the diagnosed related group (DRG) payment methodology, from continued stay service authorizations.
Summary: This Medicaid State Plan amendment complies with Section 11405 of the Inflation Reduction Act (IRA) aligning the new mandatory coverage of Medicaid adult vaccinations and the administration of the vaccines without cost-sharing.
Summary: This amendment updates preventive services, vision services, and therapy services to include physical therapy, occupational therapy, and speech-language therapy in the Alaska State Plan consistent with section 2713 of the Patient Protection and Affordable Care Act, 42 CFR § 440.130, and 45 CFR § 147.130.
Summary: This amendment adds a mandatory benefit at section 1905(a)(30) for routine patient costs for items and services furnished in connection with the participation by Medicaid beneficiaries in qualifying clinical trials, in accordance with Section 210 of the Consolidated Appropriations Act, 2021.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to waive residency requirement for individuals in state temporarily, extend reasonable opportunity period for non-citizens declaring satisfactory immigration status, suspend all cost-sharing for testing services, suspend premiums for certain populations, add temporary provisions allowing Community 1st Choice in Acute Hospital setting, allow students with completed coursework to practice as unlicensed mental health professionals, amend provider qualifications to remove First Aid & CPR requirements, expand Pharmacist scope of practice definition, increases allowable day-supply limits for prescription drugs, waive requirement for the return of unused unit dose medications dispensed in LTC based on infection control, increase reimbursement of professional dispensing fees due to incurred cost of delivery, allow the pricing methodology for covered outpatient drugs dispensed by a retail-based pharmacy to be bypassed when a medication’s acquisition cost exceeds the standard “lesser of” payment methodology logic through petitioning at the point of sale, provide exceptions to state's Preferred Drug List if a shortage occurs, and modify reimbursement to reflect a per-episode rate equal to current monthly rate for Infant Learning Program (ILP) & Long Term Services & Support (LTSS).
