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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 amendment was submitted to reduce payment rates for four procedure codes for dental crowns and for periodic orthodontic services for adults by one percent.
Summary: Revises the DSS fee schedule for durable medical equipment (DME). Specifically, the KO1108 RB modifier (wheelchair component or accessory not otherwise specified) is being reduced from $2000 to $1000. The amount is a soft limit and can be overridden with prior authorization.
Summary: This amendment was submitted to reduce payment rates for medication administration services provided by home health agencies by fifteen percent.
Summary: This SPA updates Marylands State Plan to add Applied Behavioral Analysis service to children with an Autism Spectrum Diagnosis (ASD), to satisfy requirements under EPSDT.
Summary: Updates Maryland's State Plan to clean-up inconsistencies between the State Plan and regulations, as well as fix broken website links caused during Maryland's website migration.
Summary: Increases the reimbursement rate for Targeted Case Management providers by three and a half percent, based on a legislative approved cost o living adjustment.
Summary: Add the ability for OHCQ Licensed or Certified Substance Use Disorder Program who employ a data 2000 Waiver Physician, to reimbursed for buprenorphine and other medication assisted treatment, as appropriate.
Summary: Incorporates the 2016 Healthcare Common Procedure Coding System changes to the Independent Audiology and Speech and Language Pathology fee schedule.
