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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: The purpose of this amendment is to comply with the requirements for mandatory coverage of COVID-19 vaccines, testing, and treatment without cost-sharing under section 9811 of the American Rescue Plan.
Summary: This SPA provides Pennsylvania with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
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 attest that the state covers COVID-19 vaccine, testing, and treatment without cost sharing.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to expand the provider types for the administration of the SARS-CoV-2 vaccines and amend the payment methodology for the administration of the SARS-CoV-2 vaccines to Medicaid beneficiaries who are homebound.
Summary: Effective January 1, 2021, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. CMS notes that Wisconsin covered all required MAT services to treat Opioid Use Disorder (OUD) elsewhere in the state plan prior to the January 1, 2021 effective date of the SPA.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to add pharmacists' services to other practitioners' services, to allow licensed pharmacists, pharmacy interns, and pharmacy technicians to administer COVID-19 vaccines, consistent with their scope of practice. Effective December 1, 2020, the state will pay a rate equivalent to the Medicare rate for administration of COVID-19 vaccines.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the COVID-19 vaccine administration payment rates to align with Medicare rates and allow other licensed practitioners such as pharmacists and pharmacy interns to administer the vaccine.
