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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 implements a state-directed pharmacy benefit single preferred drug list (PDL) for Fee for Service and their participating Managed Care Organizations.
Summary: This Alternative Benefit Plan (ABP) aligns the Advanced Practice Dental Hygienist approved under the Alaska State Plan as a Medicaid billing provider for the expansion population.
Summary: This amendment is to add coverage of community-based mobile crisis services. This aligns the state’s Alternative Benefit Plan (ABP) with approved SPA 24-0005.
Summary: This SPA is to align with dental plan changes made to the state plan, eliminate the $750-per-year adult dental benefit limit, to allow public health licensed dental hygienists to provide certain dental services, and to better align language in the State Plan with state regulations in 471 NAC 6.
Summary: This amendment is to eliminate the Dental Healthy Behaviors requirement and remove the basic dental benefit package from the Alternative Benefit Plan (ABP).
Summary: This amendment will allow Medicaid to exempt anti-retroviral medications used to treat HIV for the purpose of reducing viral load from Medicaid co-payments. These medications currently require a co-payment of $4 per prescription.
Summary: This Alternative Benefit Plan (ABP) amendment complies with Section 11405 of the Inflation Reduction Act (IRA) aligning the new mandatory coverage of Medicaid adult vaccinations and the administration of vaccines for the expansion population under ABP5 benefit, without cost-sharing.
Summary: This SPA amends the State Plan to allow the State to enter into value-based contract arrangements with drug manufacturers through supplemental rebate agreements.
Summary: This Alternative Benefit Plan (ABP) amendment complies with Section 11405 of the Inflation Reduction Act (IRA) aligning the new mandatory coverage of Medicaid adult vaccinations for the expansion population under ABP5 benefits.
Summary: This SPA updates language on the Delaware excluded drug coverage pages to reflect coverage of selective medications by referencing the state’s webpage and policy handbook resources instead of listing specific covered medications. Additionally, the SPA amends the Title XIX Medicaid State Plan regarding physician administered drug reimbursement rates.
