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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 allows Partial Hospitalization Program (PHP) and Intensive Outpatient Treatment (IOP) of mental health disorders related to Eating Disorder Care.
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 the Critical Access Hospital (CAH) cost report settlements. These funds will be split between inpatient CAH Adjustment Factor (CAF) settlements and outpatient CAF settlements using the same percentage split as the inpatient and outpatient CAF settlements in 2013.
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).
