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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 add homemaker services during the COVID-19 public health emergency (PHE) for Idaho’s 1915(i) HCBS Adult Developmental Disability Program. The SPA also authorizes a waiver of signatures for drug dispensing during the PHE.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow exceptions to the state's preferred drug list when shortages occur.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the suspend all cost sharing for the Work Incentives group under 1902(a)(10)(A)(XIII) of the Social Security Act and extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, and allow automatic renewal of prior authorization for medications without clinical review or time/quantity extensions.
Summary: Updates WI's drug utilization program provisions to include requirements established in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Summary: Proposes to allow the state 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).
Summary: This transmittal aligns the Idaho state plan in accordance with the Covered Outpatient Drug final rule, specifically the reimbursement of Physician Administered Drugs, and 340B contract drugs.
Summary: This SPA proposes changes to bring Wisconsin into compliance with the reimbursement requirements of the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Summary: This transmittal aligns the Idaho SPA in accordance with the actual acquisition cost (AAC) reimbursement requirements under the Covered Outpatient Drugs final rule.
