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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 requests an additional 2-year renewal of the exemption from the Recovery Audit Contractor program, from January 1, 2023 to December 31, 2024.
Summary: The state submitted this SPA to update the Standai·d Alternative Benefit Plan (ABP) to confom coverage of Medication Assisted Treatment (MAT) services. This SPA was approved November 10, 2021 with an effective date of October 1, 2020.
Summary: The state submitted this SPA to update the CarePlus Alternative Benefit Plan (ABP) to confum coverage of Medication Assisted Treatment (MAT) services.
Summary: Updates the definition of undue hardship for estate recovery; updates the state's determination of cost effectiveness for estate recovery; clarify the process for exempting certain assets from estate recovery for American Indians and Alaska Natives; and updates the limitations to estate recovery for any premiums paid on behalf of the member.
Summary: Effective April 1, 2021, this amendment increases the rates for therapeutic phlebotomy under the Outpatient hospital and physician services benefit.