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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the reimbursement rate for the Newborn Metabolic Screenings effective July 1, 2020.
Summary: This SPA provides California with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in Medicaid program.
Summary: Allows the Current Dental Terminology (CDT) dental codes to be updated from the CDT 2021 (“CDT-21”) code set to the CDT 2022 (“CDT-22”) code set for the purpose of dental service reimbursement.
Summary: Updates to the Skilled Nursing Facility Quality and Accountability Supplement Payment (QASP) for the rate period from January 1, 2022 to December 31, 2022.
Summary: This SPA amends the Alternative Benefit Plan (ABP) to restore comprehensive adult optional dental benefits, subject to medical necessity and utilization controls, for eligible adults. This SPA aligns the ABP with the restoration of adult optional dental benefits in the State Plan under the approval of SPA 17-0027.
Summary: This SPA modifies the definition of a Peer Support Specialist to be aligned with the Medi-Cal Peer Support Specialist Certification Program, which requires Peer Support Specialists to be in recovery themselves or have lived experience with the process of recovery as a parent, caregiver, or family member.
Summary: Exempts Durable Medical Equipment (DME) Complex Rehabilitation Technology (CRT) and Complex Rehabilitation Technology Services (CRTS) from the ten percent payment reductions.
