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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: 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 for the dispensing of prescription drugs during the COVID-19 Public Health Emergency.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, allow 90-day supplies of drugs and early refills, allow exceptions to the State's preferred drug list, allow use of telehealth service delivery methods in lieu of face-to-face when appropriate, and to establish supplemental payments for NF/ICF providers.
Summary: Proposes to allow the Division of Medicaid to comply with 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). This amendment also proposes to allow the Division of Medicaid to comply with the requirements outlined in Montana House Bill 86 regarding a 7-day supply limit for opioid naïve members
Summary: This amendment gives the Blackfeet Tribe of the Blackfeet Reservation, and the Gros Ventre and Assiniboine Tribes of the Ft. Belknap Reservation, authority to determine Medicaid eligibility. A2 has been amended to add this authority.
Summary: This amendment adds Collaborative Practice Drug Therapy Management as a Medicaid-covered service, as well as a corresponding reimbursement methodology to Montana' s State Plan.
Summary: Removes nonprescription bronchosaline and nonprescription pyridoxine from the excludable-but-covered nonprescription drugs section of the prescribed drugs pages.
Summary: A 2% increase in the dispensing fee to $6.78 for preferred brand name and generic drugs as well as generic drugs not identified on the preferred list.
Summary: This amendment proposed a revision of the National Medicaid Pooling Initiative Supplemental Rebate Agreement( SRA) previously submitted to CMS on September 22, 2010 to include definitions and structural changes that would provide the option of including Medicaid managed care utilization for accrual of supplemental rebates.
