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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 amendment is to add services provided by Associate Professional Clinical Counselors, under the supervision of a licensed billable practitioner, to the list of covered services for Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal FQHCs.
Summary: This plan amendment updates the rate setting methodology for freestanding skilled nursing facilities Level -B and freestanding adult subacute facilities and provides an aggregate five percent increase in the statewide weighted average labor rate component and an aggregate two percent increase in the statewide weighted average non-labor rate component for the calendar year 2023 rate year.
Summary: This plan amendment updates Medicaid reimbursement rates for physical therapy, occupational therapy, and speech-language therapy services under the home health benefit.
Summary: The District is seeking to sustain requests approved in their Temporary Extension to the Medicaid Disaster Relief COVID-19 National Emergency SPA #23-0004, which expires on May 11, 2024, by adding its language to the permanent Housing Supportive Services (HSS) 1915(i) Home and Community-Based Services SPA. If approved, this SPA will permit the HSS program to continue to utilize the appropriate determination and redetermination tools to ensure that District residents secure and maintain permanent supportive housing and to allow expanded provider qualifications for case manager supervisors.
Summary: This amendment updates the existing language to reflect the California Department of Social Services' (CDSS) updated In-Home Supports Services (IHSS) policy to allow telehealth reassessments and to reflect CDSS IHSS Quality Assurance (QA) updated practices.
Summary: This plan amendment is adding Inter-professional Consultation and Collaborative Care Services under the District’s physician services benefit.
Summary: Provide a twelve (12) month continuous eligibility period to children under age nineteen, who no longer meet eligibility requirements. This SPA will align the District's eligibility and operational practices with new federal requirements set forth under the Consolidated Appropriations Act of 2023.
Summary: This amendment allows the District to update the state’s excluded drug listing; to provide coverage for select agents for the treatment of infertility; to enter in Outcome-based arrangements with manufacturers; and to increase flexibility to improve access to prescription and over-the-counter drugs.
