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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 State Plan Amendment is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This State Plan Amendment, the state is incorporating changes that were implemented during the COVID-19 Public Health Emergency, such as adding new services, adding incentive payments for paid internships, allowing specific services the option of self-direction, and allowing specific services to be provided via telehealth.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the updates to the definition of a visit to include telehealth services in Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal Health programs and rescinds the addition of associate marriage and family therapist (AMFT) and associate clinic social workers (ASW) in FQHCs and RHCs that were originally approved under CA Disaster Relief SPA 20-0024 on May 12, 2020.
Summary: This amendment is to update the definition of a visit to include telehealth services in Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal Health programs and adds associate marriage and family therapists (AMFTs) and associate clinical social workers (ACSWs) in FQHCs and RHCs.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind approval of DR SPA 21-0016 effective 1/1/23.
Summary: This SPA establishes ongoing authority for the reimbursement methodology for Durable Medical Equipment (DME) considered to be oxygen and respiratory equipment.
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 SPA updates the the Current Dental Terminology (CDT) dental codes to the CDT 2023 (“CDT-23”) code set and the supplemental payment amount for eligible codes.
Summary: This amendment proposes to update mental health services provided under the rehabilitative services benefit to align with the department’s California Advancing and Innovating Medi-Cal (CalAIM) initiative. Specifically, the SPA removes the existing client plan requirement, clarifies site requirements for Day Rehabilitation, and makes other minor changes to service definitions and requirements.
