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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 SPA authorizes an Alternative Payment Methodology (APM) for the insertion and removal of Long-Acting Reversible Contraction (LARC) Services and for LARC devices when provided at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
Summary: This SPA is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This amendment changes to state plan coverage of other licensed practitioner services to include licensed mental health therapists, licensed social service workers, licensed substance use disorder counselors, and licensed behavioral health coaches.
Summary: This plan amendment updates inpatient reimbursement methodologies of changing cost-settled rates for critical access hospitals to cost-based rates, unbundling long-acting reversible contraceptives from general acute and critical access hospital per diems, and allowing costsettled rates for swing-bed providers.
Summary: Specifically, the amendment updates and clarifies requirements on applications submitted by facilities that choose to participate in the various QII programs.
Summary: This SPA removes specifics for identifying claims for covered outpatient drugs purchased through the 340B Program, as industry standards may periodically change.
