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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: Updates the fee schedule methodology for EPSDT, Home Pharmacy Services, Medical Supplies, and Dental services in response to a Companion Letter issued by CMS with the approval of SPA 19-0005
Summary: Establishes the Tribal Federally Qualified Health Centers (FQHC) provider type in Medi-Cal and establishes an Alternative Payment Methodology (APM) at the Indian Health Services All-Inclusive Rate for Tribal FQHCs
Summary: Adjusts the Medi-Cal Fee-for-Service (FFS) outpatient provider rates for Clinical Laboratory Services to no more than 80 percent of the lowest maximum allowance established by the federal Medicare program for the same or similar service
Summary: Increase the Blind Federal Poverty Level (FPL) and the Aged and Disabled FPL program income limits by increasing the income disregard to all countable income above the Supplemental Security Income/State Supplementary Payment (SSI/SSP) standard
Summary: Implements an income disregard to make all wages paid to an individual by the U.S. Census Bureau for temporary employment related to current or future Census activities to be exempt for Non-Modified Adjusted Gross Income (non-MAGI) Medi-Cal programs.
