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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 SPA updates Maryland's State Plan to permit state and local correctional facilities to make presumptive eligibility determinations for pregnant women, former foster care adults and the adult group eligibility groups.
Summary: This amendment will bring the District of Columbia into compliance with the reimbursement requirements of the Covered Outpatient Drug final rule with comment period (CMS-2345-FC) (81 FR 5170). Specifically, the District of Columbia proposes shifting from Estimated Acquisition Cost (EAC) to Actual Acquisition Cost (AAC) by using the National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee of $11.15. In addition, the SPA addresses coverage policies of covered outpatient drugs.
Summary: This SPA updates Maryland's State Plan to update covered outpatient drugs to include agents when used for cosmetic purposes or hair growth when medically necessary.
Summary: Clarifies the scope of services available for individuals eligible for State Plan PCA services, under the SPA recently approved by CMS, SPA #15-007.
Summary: This SPA creates a new bundled daily rate for Community First Choice providers delivering more than 12 hours daily to participants as directed by their plan of service.
Summary: This amendment delineates the process upon which the District will establish its Medicaid Asset Verification Program, inclusive of a plan for systems development and a process which verification will be established.
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.
