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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 amendment updates the date of the fee schedule for state plan services on the Introduction Page. This will allow the department to update Medicaid fees, additions, deletions, or changes to procedure codes when Medicare releases and updates their fee schedule.
Summary: This amendment addresses third party liability and related Medicaid payments associated with prenatal care, preventive pediatric services, and medical child support.
Summary: Effective October 1, 2021 this amendment removes federally optional liens and recoveries. This amendment updates third-party liability section to reflect current law and practice with respect to the BBA of 2018 and it removes the language regarding the cost effectiveness premium purchase program for group health insurance that is authorized under section 1906 of the SSA.
Summary: This amendment establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
Summary: This amendment removes coverage of the Nurse Advice Line from the state plan as the result of increased access to primary care advice through telehealth.
Summary: On March 31, 2022, the Centers for Medicare and Medicaid Services (CMS) received Montana State Plan Amendment (SPA) MT-22-0002, in which the state proposed to increase the general income disregard for medically needy individuals from $100 to $269 per month, and to further modify the disregard consistent with Social Security Administration cost-of-living adjustments beginning in 2023 and in subsequent years.
