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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: The Department is amending the State Plan to include language to clarify the specific Medicare rate used to set the Maryland rate for Medicare-covered Durable Medical Equipment (DME) and Durable Medical Supplies (DMS).
Summary: The purpose of the amendment is to update the quality measures and associated weights for the health home quality incentive payment methodology. The updated methodology was reduced from ten weighted measures to seven. The total quality incentive payment pool for this disbursement remained the same
Summary: Modifies the language that describes the rate categories for the Program of All-Inclusive Care for the Elderly (PACE) by removing the QMB rates in the rate-setting methodology. This change does not fundamentally change the formula for rate calculation.
Summary: This plan amendment implements a 4% rate increase for the Developmental Disabilities Administration Targeted Case Management (DDA TCM) program.
Summary: This amendment extends the supplemental payments for qualifying, private hospitals and nursing facilities for an additional state fiscal year.
Summary: This State Plan Amendment implements a 16% inflationary increase for Community Mental Health Centers and Substance Use Disorder Agencies appropriated by the state legislature.
Summary: To include coverage for peer recovery support services within the state’s Other Diagnostic, Screening, Preventive and Rehabilitative Services benefit and the Mandatory Medication-Assisted Treatment (MAT) benefit. Individual peer support services will be reimbursed at a rate of $16.38 per 15-minute unit, and group peer support services will be reimbursed at a rate of $4.55 per 15-minute unit. This SPA also removes the DATA 2000 waiver requirement for the prescribing of buprenorphone for opioid use disorder.
Summary: 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.
