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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 amendment is part of the Alternative Benefit Plan (ABP) required for the adult population for Medicaid expansion. Specifically, this ABP is for the Consolidated Appropriations Act (CAA) coverage of routine costs associated with qualifying clinical trials.
Summary: To update State Plan language regarding the EPSDT program, including eligible provider types, clarifying limitations to dental and audiological services, and removing references to the 504 Written Individualized Program.
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: 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 update the State Plan language to comply with the amended section 1905(a)(30) of the Social Security Act, assuring coverage to eligible Medicaid participants for routine patient costs for otherwise covered items and services resulting from a qualifying clinical trial.
Summary: To update the State Plan language regarding the guidance on in-patient delivery hospital stays, clarifying the authorization requirements for both vaginal and cesarean deliveries.
