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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: Allows State to Add New Managed Care Contractors When Needed, to Allow for Integrated Healthcare Delivery in Select Areas of the State, and to Update the Pre-Print To Its Most Recent Version.
Summary: Clarifies the reimbursement methodologies for claims paid under the fee-for-service Prescription Drug Program and describes the reimbursement methodology for drugs paid under the Physician Services program.
Summary: Removes sunset language that was included in the state's initial 1915(k) Community First Choice WA-15-0002 submission regarding provider trainings and other Home and Community-Based settings requirements that the state has completed.
Summary: This SPA streamlined the FMAP identification process for individuals receiving cash assistance under the state's Aged Blind and Disabled (ABD) program.
Summary: Updated the effective dates of the fee schedules for several Medicaid services, including; All other practitioners and Targeted Case Management for infants and parents.
Summary: This SPA updated the effective date for fee schedules for various programs and incorporated language to eliminate quarterly SPA submissions that simply updated the effective date.