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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: State Plan Amendment (SPA) 22-0025 was submitted to allow the Division of Medicaid (DOM) to update the disproportionate share hospital (DSH) redistribution methodology following annual audits to allow
all providers who were underpaid to receive additional payment.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to allow for Emergency Case Management services provided during the Public Health Emergency (PHE) to continue to be provided until January 1, 2024.
Summary: This SPA is being submitted to comply with the ARP requirements for coverage of COVID-19 treatment or for a condition that may seriously complicate the treatment of COVID-19.
Summary: This SPA is being submitted to allow the Division of Medicaid (DOM) to update the rates for durable medical equipment (DME) and Medical Supplies October 1, 2022 and July 1 of each year thereafter based on the Medicare Rural Rate in effect January 1 of that year, effective October 1, 2022.
Summary: State Plan Amendment (SPA) 22-0026 is being submitted to allow the Division of Medicaid (DOM) to update the rates for ambulatory surgical centers (ASCs) October 1 of each year, based on the Medicare rate in effect July 1 of that year.
