An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: 1) to supply assurances that it is complying with new third party liability requirements authorized under the Consolidated Appropriations Act, 2022 and 2) to provide clarity on the state’s option to adopt a new flexibility on creating liens for injury settlement proceeds attributable to future medical expenses.
Summary: This SPA eliminates the sunset date for approved supplemental payments and Alternative Payment Methodologies (APMs) for trauma screenings and developmental screenings.
Summary: This amendment, the state is expanding the needs-based criteria for children under five, adds Participant-Directed Services and related budget authority, and adds incentive payments to providers who assist individuals with obtaining competitive and integrated employment.
Summary: This SPA amends the State plan pages to reimburse providers based on a submitted invoice price for a drug’s ingredient cost when other pricing benchmarks are unavailable.
Summary: DESCRIPTION: Proposes several changes to update, clarify, and streamline language in the state plan. The proposed changes include: 1) streamlining language that describes certain therapy modalities, which are available under the Counseling/Therapy service benefit, 2) updating supervision requirements for behavioral health providers in Federally Qualified Health Centers (consistent with District Law), 3) clarifying education and experience requirements for credentialed staff able to provide State Plan rehabilitative services, and 4) updating rates for select behavioral health services according to the fee schedule.
Summary: This amendment is to add Licensed Professional Clinical Counselors (LPCCs) to the list of billable practitioners providing services at Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and Tribal FQHCs.
Summary: This amendment is to expand the prescribing authority for enteral formulae from physicians to include physicians, nurse practitioners, clinical nurse specialists, or physician assistants.
