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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 2020 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Radiology and Independent Laboratory fee schedules
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to expand timeframes for evaluation and re-authorization of Plans of Care for Targeted Case Management (TCM) benefits, expand the duration of TCM benefits, allow the use of telephonic methods in lieu of face-to-face interactions when appropriate, expand the provider types allowed to prescribe Home Health Services, allow Community First Choice providers to temporarily hire family members and legally responsible individuals to provide personal care assistance, expand access to Remote Patient Monitoring, and permit the Department to pay for non-emergency transportation services either directly or through grants to local health departments.
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 suspend certain premium payments required under Maryland’s Medicaid state plan.
Summary: Updates the State’s Asset Verification System (AVS) reflecting the State’s decision to go from using a contractor to build the system to joining a consortium to develop an Asset Verification System
Summary: Proposes to update the payment rates for nursing facility residents to provide for reimbursement when a resident of a Disaster Struck Nursing Facility must be temporarily evacuated to another facility due to a disaster for a period of up to thirty (30) days.
Summary: Updates the physician office and outpatient fee schedule to increase the rates for select Long-Acting Reversible Contraceptive (LARCs) Devices and updates the pricing methodology for specified codes on the physician-surgery fee schedule for manually priced to a fixed fee at 57.5% of Medicare
Summary: Updates the physician office and outpatient fee schedule by restructuring the payment methodology for pediatric medical providers who apply fluoride varnish to the teeth of Medicaid members and expands the age range of individuals who can receive an oral assessment and/or application of fluoride varnish by a pediatric medical provider.
