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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: Clarifies the methodology by which transportation benefits will be provided including coverage for escorts; detail when prior authorization is required and establishes a payment methodology for such services.
Summary: Clarifies coverage provisions, including but not limited to prior authorization requirements in the areas of EPSDT services, FFQHC services, laboratory and x-ray services, family planning services, dentures, and prosthetic devices.
Summary: Clarifies coverage provisions, including but not limited to prior authorization requirements in the areas of EPSDT services, FFQHC services, laboratory and x-ray services, family planning services, dentures, and prosthetic devices.
Summary: This SPA adds to the State plan, under diagnostic services, an environmental home lead investigation for children with high blood lead levels.
Summary: This SPA permits the State to disregard all wages paid by the Census Bureau for temporary employment related to Census activities. In addition, this amendment permits the State to cover, as an optional group other than the Medically Needy, individuals who would be eligible for AFDC, SSI, or an optional State supplement as specified in 42 CFR 435.230, if they were not in a medical institution.
Summary: This SPA proposes to add Employed Individuals with Disabilities into the State plan under the eligibility groups authorized under section 1902( a)(1 O)(A)(ii)(XV) of the Social Security Act.
