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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 proposed to adopt the 12-month continuous eligibility mandate for children, extend the initial transitional medical assistance (TMA) period from six months to 12, and elect the option to require less than three months of eligibility or enrollment in the parent/caretaker relative eligibility group for TMA eligibility.
Summary: This amendment proposed to document the new income standards for its optional state supplement program, beneficiaries of which are eligible for Medicaid under Vermont's State Plan.
Summary: This amendment proposes to change the eligibility rules for the Former Foster Care Children eligibility groups, as enacted by the Substance Use-Disorder Prevention that Promotes Opiod Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
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 rescind premiums and cost-sharing. It reverts to co-pay amounts prior to the public health emergency (PHE) with exception of services, drugs, test and vaccines for treatment of COVID-19.
Summary: disregard two sources of income/resources: 1) any refundable credit against taxes made pursuant to Vermont's child tax credit or pursuant to a similar tax credit enacted by the State and intended by legislation to not be considered as countable income or resources for benefit programs; and 2) any wages that are made pursuant to Vermont's Premium Pay for Workforce Recruitment and Retention Program or a similar workforce recruitment and retention program enacted in Vermont and intended by the legislature to not be considered as countable income or resources in determining eligibility for benefit programs.
Summary: Effective January 1, 2021, this amendment updates the State Supplementary Payment levels for the "Optional State Supplement Beneficiaries" eligibility group.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend co-payment obligations for outpatient hospital visits and for medications to treat the symptoms of COVID-19, remove 9-hour per week minimum for substance use disorder services and intensive outpatient treatment services (including alternative benefit plans), expand prior authorization for medications by automatic renewal, and make exceptions for brand name drugs.
Summary: This eligibility SPA expands eligibility for the Medicaid for Working People with Disabilities (MWPD) program by disregarding certain types of income and by increasing the resource limits.
