An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: Updates to the paper application, and the state’s election to use an alternative single, streamlined application developed by the state for individuals applying for coverage who may be eligible based on the applicable modified adjusted gross income standard
Summary: Makes a technical change previously announced in SPA ID MD-18-0005 to reflect integration into the streamlined application and update the reviewable units for Family Planning to apply the MAGI household rules and income rules to Family Planning Applicants
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to expand timeframes for evaluation and re-authorization of Plans of Care for Targeted Case Management (TCM) benefits, expand the duration of TCM benefits, allow the use of telephonic methods in lieu of face-to-face interactions when appropriate, expand the provider types allowed to prescribe Home Health Services, allow Community First Choice providers to temporarily hire family members and legally responsible individuals to provide personal care assistance, expand access to Remote Patient Monitoring, and permit the Department to pay for non-emergency transportation services either directly or through grants to local health departments.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to suspend certain premium payments required under Maryland’s Medicaid state plan.
Summary: This SPA allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.
Summary: Includes new drug review and utilization requirements set forth in section 1902(oo) of the Act. Specifically, Maryland is updating language to identify claim review limitations on safety edits and retrospective reviews, programs to monitor antipsychotic medications to children and fraud and abuse identification requirements
Summary: changes to Hospital Presumptive Eligibility (HPE), modifications to Presumptive Eligibility (PE) for Pregnant Women, the Eligibility Process Reviewable Unit, and the state’s election to end the option to provide Presumptive Eligibility to children under age 1.
