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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: Effective for services on or July 1,2021, this amendment updates the supplemental payment methodology to hospitals for inpatient and outpatient services. Specifically, these changes will associate supplemental payments with quality of services and participation in the Healthy Connections Value Care (HCVC) program, further linking inpatient and outpatient hospital services to quality and value of patient care.
Summary: Renewing Idaho’s Home and Community Base Services (HCBS)1915, Yes Empowerment Services (YES) State Plan Benefit, targeting children with serious emotional disturbances (SED). This benefit will provide respite services for children and youth who have a substantial functional impairment that is measured by and documented through the use of a standardized instrument conducted or supervised by a qualified independent assessor clinician.
Summary: For dates of service beginning August 1, 2022, the Department is establishing reimbursement methods for vaccine administration for federally purchased vaccines to adults (e.g. COVID-19). MDH is providing payment for administration of monkeypox and/or smallpox vaccinations at a rate of $23.28 per dose.
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.
