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CMS Approves State Plans to Mitigate COVID-19

The Center for Medicare & Medicaid Services (CMS) has swiftly approved several state plan amendments (SPAs) related to the COVID-19 pandemic.

CMS previously released a toolkit for state Medicaid and Children’s Health Insurance Program agencies, outlining available resources and flexibility to respond to the COVID-19 pandemic. The toolkit includes a Medicaid Disaster SPA template and an accompanying document detailing how to apply.

To date, CMS has approved seven time-limited Medicaid disaster SPAs that request program changes, such as removing requirements for cost-sharing and prior authorization.


CMS approved two SPAs for Alabama. The first SPA, approved April 6, allows the state to suspend co-payments for all services provided to Medicaid beneficiaries and allows the use of telehealth for certain Medicaid services. On April 7, CMS approved a second SPA removing requirements that restrict ambulance service destinations and prior authorization for non-emergency ambulance services during the COVID-19 emergency.


Arizona’s SPA, approved April 1, expands Medicaid eligibility to cover COVID-19 testing for the uninsured; streamlines enrollment for children whose families have experienced income changes during the crisis; suspends all cost-sharing and premiums; and expands access to covered outpatient drugs.


On April 6, CMS approved Minnesota’s SPA waiving cost-sharing for COVID testing and treatment; suspending disenrollment due to failure to pay premiums for working, disabled beneficiaries; expanding telehealth; and allowing 90-day refills without prior authorization for certain maintenance drugs.


On March 25, CMS approved two SPAs for Washington state related to the COVID-19 emergency. The first SPA addresses supplemental payments for transportation-related services during the state of emergency issued by the governor on Feb. 29. The second SPA supports the delivery of health care services through telehealth.


On April 7, CMS approved Wyoming’s SPA to suspend premiums for the state’s employed individuals with disabilities program eligibility group.

America’s Essential Hospitals has created a coronavirus resource page that provides up-to-date information about the outbreak.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Abigail Painchaud is a policy associate at America's Essential Hospitals.

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