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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 is to extend the temporary rates for intermediate care facilities for individuals with intellectual disabilities (ICF/IID).
Summary: This plan amendment updates rates for Physician, Free Standing Birth Centers, Early and Periodic Screening Diagnostic, and and Treatment (EPSDT), and Dental Services.
Summary: This amendment makes provisions governing the medical transportation program to establish guidelines for the administration and distribution of Elevated Level of Care (ELOC) services by non-emergency medical transportation (NEMT) vendors that meet the criteria to provide an ELOC service to Medical beneficiaries, and to clarify language regarding non-emergency medical ambulance transportation (NEAT) services.
Summary: This amendment allows provisions governing the Pharmacy Benefits Management Program to update the copay tier payment schedule to align with the U.S. Department of Health and Human Service, CMS, recommended guidelines.
Summary: This amendment proposes to add coverage for Post Permanency Supports Targeted Case Management for children whose families are formed through adoption and guardianship in Vermont.
Summary: This amendment amends the provisions governing opioid treatment programs in order to expand the types of eligible practitioners who can treat individuals and prescribe medications in medication-assisted treatment (MAT).
Summary: This Amendment adds assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set.
Summary: This amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15. Vermont is also updating the converted MMDL language in the Health Homes SPA to include the assurance in accordance with federally mandated quality reporting for the Health Home Core Set as outlined with requirements in 42 CFR §§ 437.10 through 437.15 .
Summary: This SPA is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
