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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: Health Homes Payment Methodologies Under this SPA, for dates of service beginning July 1, 2024, the Maryland Medical Assistance Behavioral Health, Health Home program reimbursement rates will increase by 3%.
Summary: To permanently eliminate the premium payment requirement for children enrolled in MCHP with a family income 212 to 322 percent of the federal poverty limit.
Summary: This SPA allows Maryland to cover select imported drugs due to shortages identified by the Food and Drug Administration, as well as to provide the reimbursement methodology for select prescribed drugs.
Summary: This amendment is to suspend temporarily pharmacy co-payments for dates of service starting February 21, 2024, through March 18, 2024, in response to the Change Healthcare cybersecurity incident in alignment with the CMCS Informational Bulletin.
Summary: This amendment proposed to adopt the 12-month continuous eligibility mandate for children, extend the initial transitional medical assistance (TMA) period from six months to 12, and elect the option to require less than three months of eligibility or enrollment in the parent/caretaker relative eligibility group for TMA eligibility.
Summary: This amendment proposed to document the new income standards for its optional state supplement program, beneficiaries of which are eligible for Medicaid under Vermont's State Plan.
