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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: State Plan Amendment (SPA) 23-0032 allows the Division of Medicaid (DOM) to update reimbursement of dental services provided in an ambulatory surgical center (ASC). For ASC dental services that do not have a fee on the Medicare ASC Fee Schedule, effective December 1, 2023, the SPA will allow ASC’s to be reimbursed at eighty percent (80%) of the Medicare rate that was in effect January 1, 2023, for the most comparable hospital outpatient service.
Summary: This MD Behavioral Health, Health home SPA increases provider rates by 3 percent pursuant to its passed state Senate/House bill for its 2024 state budget
Summary: The purpose of this amendment is to allow the Division of Medicaid (DOM) to include beneficiaries diagnosed with hemophilia in the MississippiCAN program.
Summary: To comply with federal requirements under section 5512 of the Consolidated Appropriations Act, 2023 (CAA 2023) to provide 12 months of continuous eligibility for children in Medicaid and the Children’s Health Insurance Program (CHIP) on or before January 1, 2024.
Summary: The Maryland Department of Health is submitting this SPA to implement a 3% rate increase, provided through the Maryland Budget Bill, for the 1915(i) Home and Community-Based Services Program.
Summary: To include a self-directed model for some Community First Choice (CFC) services, implement changes to the current Electronic Visit Verification (EVV) requirements for CFC, and better align the State Plan with current practice regarding CFC covered services, limitations, and the program’s quality improvement strategy. CMS conducted the review of the state’s submittal according to statutory requirements in Title XIX of the Social Security Act and relevant federal regulations.
Summary: This SPA allows the Division of Medicaid (DOM) to increase the reimbursement rates for certain mental health services by 15.8% with half of the increase implemented in State Fiscal Year (SFY) 2024 and the second half of the increase implemented in SFY 2025. Rates are effective for services provided on or after July 1 for each year.
