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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.
To comply with federal requirements under section 5512 of the Consolidated Appropriations Act, 2023 (CAA 2023) to provide 12 months of continuous eligibility for children in Medicaid and the Children’s Health Insurance Program (CHIP) on or before January 1, 2024.
To include a self-directed model for some Community First Choice (CFC) services, implement changes to the current Electronic Visit Verification (EVV) requirements for CFC, and better align the State Plan with current practice regarding CFC covered services, limitations, and the program’s quality improvement strategy. CMS conducted the review of the state’s submittal according to statutory requirements in Title XIX of the Social Security Act and relevant federal regulations.
Summary: To adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid 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 allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to continue a premium resumption delay for the following group from the day after the end of the federal PHE through December 31, 2023: Employed Individuals With Disabilities (§1902(a)(10)(A)(ii)(XV) TWWIIA Basic group) and a premium resumption delay for the following group from the day after the end of the PHE through April 30, 2024: Maryland Children's Health Program (MCHP) (§1902(a)(10)(A)(ii)(XIV) targeted low-income children).
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 disregard resource income for ABD groups during the Public Health Emergency (PHE) and to waive any signature requirements for the dispensing of drugs, to permit provision of a 14-day emergency supply, instead of a 72-hour emergency supply of prescribed drug, and to waive of prior authorization requirements for non-preferred drugs.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to permit flexibility regarding preparation of eligibility applications in - person by caseworkers employed by the State of Maryland and navigators.
Summary: To update the State Plan language regarding the guidance on in-patient delivery hospital stays, clarifying the authorization requirements for both vaginal and cesarean deliveries.
