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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 existing language for EPSDT prevention and and wellness services to be consistent with the Essential Health Benefit 09 description in the Alternative Benefit Plan.
Summary: Allows registered dental hygienists , registered dental hygienists in extended functions and registered dental hygienists in alternative practice to enroll as Medi-Cal dental program billing providers.
Summary: This SPA makes revisions to the reimbursement methodologies for the Short-Doyle/Medi-Cal acute inpatient services and Short-Doyle/Medi-Cal outpatient, rehabilitation, case management and other services.
Summary: This SPA updates the Coordination of Benefits/Third Party Liability (COB/TPL) cost-effectiveness threshold amounts and makes adjustments to the trauma code editing protocols.
Summary: This SPA extends Medicaid coverage for an initial period of 12 months for low-income families who no longer qualify for Medicaid due to increased earned income or working hours from the caretaker relative's employment, or due to the loss of a time-limited earned income disregard.
Summary: To provide technical updates for prosthetic and orthotic appliances and hearing aids to reflect that these appliances are covered when prescribed by a physician or other licensed practitioner, instead of physician or podiatrist.
