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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: This plan incorporates the 2021 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the medical surgical supply fee schedule.
Summary: Incorporates the January 2022 federal Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the dental fee schedules for adults and children.
Summary: Allows reimbursement changes for private intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs). Specifically, this SPA provides specified fair rent increases and implements a rate increase of 4.3% to pay for costs of wage and benefit enhancements.
Summary: Effective January 1, 2022 this amendment proposes to add mandatory coverage of routine patient costs furnished in connection with participation in qualifying clinical trials.
Summary: This amendment adds a mandatory benefit at section 1905(a)(30) for routine patient costs for items and services furnished in connection with the participation by Medicaid beneficiaries in qualifying clinical trials, in accordance with Section 210 of the Consolidated Appropriations Act, 2021.
Summary: This amendment updates Alaska’s Alternative Benefit Plan to align with Alaska’s Medicaid State Plan implementing the mandatory benefit under section 1905(a)(30) in accordance with Section 210 of the Consolidated Appropriations Act, 2021.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement coverage and payment changes to section 1915 Connecticut Home Care Program for Elders (CHCPE) Services and section 1915(k) community first choice services consistent with the state’s ARPA section 9817 HCGS spending plan.
Summary: Effective December 1, 2021 through December 31, 2023, this amendment makes changes to reimbursement for pediatric psychiatric inpatient hospital services.
