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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: Alternative Benefit Plan - Adds community-based providers that are the same providers the State previously licensed for other levels of care, but will now be able to receive a license to operate additional levels of care.
Summary: Adds partial hospitalization, ambulatory detox and buprenorphine induction as services for community-based substance use disorders and moves opioid treatment programs under community-based substance use disorders.
Summary: This SPA proposes to limit the number of outpatient pharmacy prescriptions for all recipients, with certain class exemptions, to five total drugs per month per adult recipient.
Summary: Removes limits on certain hospital services and to change the funding methodology for public hospital disproportionate share hospital payments.
Summary: This SPA updates the State Plan to reflect changes to the State's dental services fee schedule and procedure codes, as well as adding ambulatory surgical centers as a covered service location.
Summary: Allows Medicaid to align with the requirements of the Alabama Board of Medical Examiner's Administrative Code for Qualifications and Limitations of Physician's and Physician Extenders (e.g. nurse practitioners, physician assistants).
Summary: This SPA adopts a prospective payment system for Maryland nursing facility services based on actuity adjusted resource utilization groups and reimburses capital costs through fair rental value.
