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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 revise the percentage of net invoice cost paid for Outpatient Hospital Physician Administered Drugs.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to cover COVID-19 drug treatment provided through Emergency Use Authorization effective March 1, 2020, increase the rate for procedure code 36561 from Ambulatory Surgical Center (ASC) grouper3 to ASC grouper 10, effective August 26, 2021, and increase the reimbursement rate for administration of a COVID-19 vaccine effective September 1, 2021.
Summary: This amendment proposes to implement temporary policies, which are different from those policies and procedures otherwise applied under your Medicaid state plan, during the period of the Presidential and Secretarial emergency declarations related to the COVID- 19 outbreak (or any renewals thereof).
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide flexibilities in the areas of home health, transportation, telemedicine, inpatient hospital services, and pharmacy benefits.
Summary: This SPA revises the state plan to incorporate language that authorizes the state to enter into value-based contract arrangements with drug manufacturers through supplemental rebate agreements.
Summary: This SPA proposes to bring Colorado into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC), such as provisions in 42 CFR 447.518(a).
Summary: This SPA increases reimbursement rates for office visits and vaccine administration and removes the 42 CFR 405 payment increase that expired on December 31, 2014.
