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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: Allows hospitals in the state to determine eligibility presumptively under the option. And the state to allow Medicaid coverage for individuals determined presumptively eligible under this provision.
Summary: To incorporate the methodology used by the Commonwealth to determine the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable to the medical assistance expenditures for enrollees in the new adult eligibility group adopted by the Commonwelth and described in 42 CFR 435.119.
Summary: This amendment covers and reimburses all United States Preventive Services Task Force (USPSTF) grade A and B clinical preventive services and approved adult vaccines and their administration recommended by the Advisory Committee on Immunization Practices (ACIP), without costsharing; and establishes a one percentage point increase in federal medical assistance percentage (FMAP) for these service expenditures whether they are provided in fee-for-service (FFS), managed care or under an alternate benefit plan.
Summary: This SPA describes the methodology used by the State for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the State and described in 42 CFR §435.119.
