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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: Updates the State Plan language regarding the Community First Choice program to replace references to the attendant care and the LTSS tracking System with personal assistance services and data management.
Summary: This SPA provides the District of Columbia with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: To implement a Home Visiting Services program to offer informational support, and facilitate screening and care coordination to support healthy outcomes through pregnancy and up to a child’s second or third birthday, depending on the program of enrollment. Services will be provided by specially trained professionals within the Healthy Families America (HFA) and Nurse Family Partnership (NFP) services programs.
Summary: To implement coverage for doula services including continuous physical, emotional, and informational support to the birthing parent during the prenatal, labor & delivery, and postpartum periods.
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: To add coverage to the District of Columbia’s Alternative Benefit Plan Medicaid Expansion, Routine Patient Cost in Qualifying Clinical Trials.
Summary: To effectuate the coverage of routine patient costs incurred during qualified clinical trials from January 1, 2022 forward, as required by the Consolidated Appropriations Act, 2021, Division CC, Title II, Section 210.
Summary: To allow the District to transition its Section 1115 Behavioral Health Transformation Demonstration Program services to permanent State Plan authority in order to retain authority to provide Medicaid reimbursement.
