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: This plan amendment increases 18 select primary care and OB/GYN codes to the 2020 Medicare levels (rates) for those physicians eligible for enhanced rates.
Summary: Effective July 1, 2021, this amendment revises the hospital auditing program to allow desk reviews/audits and focus reviews in lieu of on-site field audits. Current technology allows audits to be performed remotely instead of on-site or in-person.
Summary: Effective August 14, 2020, this amendment increases the reimbursement for ventilator dependent nursing facility residents. Specifically, this amendment proposes to increase the nursing facility per diem for a ventilator dependent resident by 3%. The rate will increase from $540.55 to $556.77.
Summary: Effective August 14, 2020, this amendment implements a quality incentive for nursing homes that receive national quality award status or accreditation.
Summary: Effective October 1, 2020, this amendment permits the District of Columbia to provide medication-assisted treatment (MAT) for opioids use disorder (OUD) as a mandatory state plan benefit in compliance with section 1006(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). The SPA assures that the District covers as a mandatory benefit all FDA approved MAT drugs, FDA licensed MAT biological products, and MAT behavioral counseling and therapy services.
