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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: To reimburse for community violence prevention services. Coverage will be extending to this service at a fee-for-service rate of $32.76 per 30-minute increments up to a maximum of 100 increments in a rolling 12-month period.
Summary: The state proposed to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This plan amendment will allow treatment in place and mobile integrated health services to be provided by emergency services transporters under the supervision of a physician. Treatment in place will reimburse at a rate of $150 and mobile integrated health services will reimburse at a rate of $150 per event.
Summary: This state plan amendment eliminates certain hospital rate enhancements (AREs) from the state plan and updates Diagnosis Related Group (DRG) reimbursement rates for hospital inpatient services in order to adjust rates for providers that previously received AREs and participated or did not participate in year one of the state's Directed Payment Program (DPP). The amendment also increases payments for the purpose of raising wages for employees of Medicaid providers to at least $15.00 per hour, includes a Children’s Hospital per-discharge add-on payment, modifies the payment methodology for GME to update the list of specialties in statewide supply-and-demand deficit, adds funding for mental health and psychiatry resident positions, provides an increase in the organ transplant provider rate, and makes technical and editorial changes.
Summary: This state plan amendment updates Long-Term Care Reimbursement provisions related to provider submission requirements when submitting annual Fair Rental Value (FRV) surveys, specifies that the state may amend FRV survey data based on audit results, removes a transitional rate provision in place since 2016 that reimbursed at the greater of a provider's prospective payment rate or its previous cost-based rate, increases funding to providers to establish a legislatively mandated $15.00 minimum wage, and updates State Plan UPL methodology to specify the use of the most recent cost reports for 2022-2023 UPL calculation.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to continue a premium resumption delay for the following group from the day after the end of the federal PHE through December 31, 2023: Employed Individuals With Disabilities (§1902(a)(10)(A)(ii)(XV) TWWIIA Basic group) and a premium resumption delay for the following group from the day after the end of the PHE through April 30, 2024: Maryland Children's Health Program (MCHP) (§1902(a)(10)(A)(ii)(XIV) targeted low-income children).
Summary: This SPA proposes to update physician administered drug reimbursement, over-the-counter drug coverage, and current age restrictions on existing vaccination language that includes coverage of certain vaccines to individuals that reside in institutions.
