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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: Incorporates the January 2022 federal Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the dental fee schedules for adults and children.
Summary: Updates the 12-month cap period, beginning on October 1 of each year and ending on September 30 of the following year for hospice care reimbursement.
Summary: To update Maryland State Plan language to reflect current audiology prosthetic device coverage as outlined in the Code of Maryland Regulations (COMAR).
Summary: Allows reimbursement changes for private intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs). Specifically, this SPA provides specified fair rent increases and implements a rate increase of 4.3% to pay for costs of wage and benefit enhancements.
Summary: Effective January 1, 2022 this amendment proposes to add mandatory coverage of routine patient costs furnished in connection with participation in qualifying clinical trials.
Summary: To update the State Plan language to comply with the amended section 1905(a)(30) of the Social Security Act, assuring coverage to eligible Medicaid participants for routine patient costs for otherwise covered items and services resulting from a qualifying clinical trial.
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.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement coverage and payment changes to section 1915 Connecticut Home Care Program for Elders (CHCPE) Services and section 1915(k) community first choice services consistent with the state’s ARPA section 9817 HCGS spending plan.
Summary: Effective December 1, 2021 through December 31, 2023, this amendment makes changes to reimbursement for pediatric psychiatric inpatient hospital services.
