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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to disregard resource income for ABD groups during the Public Health Emergency (PHE) and to waive any signature requirements for the dispensing of drugs, to permit provision of a 14-day emergency supply, instead of a 72-hour emergency supply of prescribed drug, and to waive of prior authorization requirements for non-preferred drugs.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to permit flexibility regarding preparation of eligibility applications in - person by caseworkers employed by the State of Maryland and navigators.
Summary: This action assures that Maryland’s coverage and reimbursement for COVID-19 vaccines, testing, and treatment during the mandatory American Rescue Plan (ARP) period aligns with section 1905(a)(4)(F) of the Social Security Act.
Summary: This SPA updates reimburse Medicare-covered equipment at 85% of the Medicare rates established on January 1 of each year. This increase is in accordance with the enacted budget approved for FY 2023.
Summary: Implements an 8% rate increase for the Developmental Disabilities Administration Targeted Case Management (DDA TCM) program. In addition, a temporary 10 % rate increase for DDA TCM services using 100 % 9817 generated savings funds for dates of service 10/1/22 through 12/31/22 and on January 1, 2023, the rates will revert back to the rates approved on 07/01/2022.
Summary: This amendment adds mandatory coverage of routine patient costs in qualifying clinical trials per the Consolidated Appropriations Act of 2021 to the state's ABP.