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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 SPA adds language that was inadvertently dropped on Maryland SPA 11-04, which expanded coverage to otherwise pregnant women and children who are aliens, under the Childrens Health Insurance Program Reauthorization Act (CHIPRA) Section 214 option.
Summary: This is a Pharmacy SPA: it reduces dispensing fees by five percent. In addition, this amendment adds language regarding coverage of smoking cessation products for pregnant women to the pharmacy section of the State Plan. The pharmacy section has also been reformated for improved organization and clarity.
Summary: This SPA, in accordance with Section 113 of the Childrens Health Insurance Program Reauthorization Act (CHIPRA), eliminates the previous requirements for deemed newborn Medicaid eligibility that the newborn must come home from the hospital to live with the mother, remain a member of the mothers household, and that the mother remain eligible for Medicaid, or would remain eligible if still pregnant. By virtue of this change, all newborns born to women covered by Medicaid for the child's birth, including coverage of an alien for labor and delivery as emergency medical services, are now covered as mandatory categorically needy.
Summary: Updates certain State plan pages, including non-discrimination practices, methods of assuring high quality care, removal of language on guidelines for assessing costeffectiveness of employer-based group health plans, and the definition of a claim.
Summary: Provides hospice services to children eligible for Medicaid and children eligible for the Medicaid expansion Children Health Insurance Program.
Summary: This SPA extends outpatient psychiatric care as a physician service through video telemental health technologies for eligible individuals in designated rural areas.
Summary: This SPA ensures compliance with the Qualifying Individual Program Supplemental Funding Act of 2008, whereby the State has an eligibility determination system that provides for data matching with medical assistance programs operated by other States in order to prevent duplicate enrollments.
Summary: This SPA implements Express Lane Eligibility for children, in which the Maryland Comptroller will identify through annual State income tax returns those families who are below 300 percent of the Federal Poverty Level and who indicate that their children do not have health insurance coverage.