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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 LTCSS assessment requirements for beneficiaries receiving PCA services to align with changes made to the District’s assessment process and corresponding regulations
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 temporarily modify the State Plan reimbursement methodology for FQHCs to establish a new alternative payment methodology (APM) as authorized in Section 1902(bb)(6) of the SSA.
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to expand Telehealth, adjustments to 1915(i) adult day health services, adjust day supply limits to allow and reimburse for dispensing of a 90-day supply of maintenance medications, waive physician authorization for LTCSS assessment and request for re-assessment, modify certain payment rates, and to modify the My Health GPS health home program to eliminate acuity tiers, face-to-face requirements, and update care team staffing requirements as well as modify reimbursement methodology.
Summary: Makes a technical change previously announced in SPA ID MD-18-0005 to reflect integration into the streamlined application and update the reviewable units for Family Planning to apply the MAGI household rules and income rules to Family Planning Applicants
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 District's hospice care reimbursement methodology to align with federal requirements and enable the District to improve monitoring and oversight of the delivery of hospice services