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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: The SPA implements a 90-day grace period for behavior technicians to be covered under the other licensed practitioner Medicaid benefit while working to acquire the Registered Behavior Technician credential.
Summary: This SPA changes the MO HealthNet Dental Program to allow eligible MO HealthNet participants aged 21 and older to receive periodic oral evaluations. The SPA also allows MO HealthNet-enrolled dental providers to provide and receive reimbursement for the evaluations rendered.
Summary: This plan amendment updates the Disproportionate Share Hospital (DSH) program reimbursement methodology and revises the DSH allotment distributed among eligible hospitals.
Summary: This amendment updates State Plan language regarding the Community First Choice program to reduce the provider requirements for emergency response.
Summary: This amendment is to provide children under age 19 with 12 months of continuous eligibility in Medicaid, in accordance with Section 1902(e)(12) of the Social Security Act, as amended by Section 5112 of the Consolidated Appropriations Act, 2023. Children under age 19 will remain continuously eligible for the full 12-month certification period, regardless of changes in circumstances with certain exceptions.
Summary: This amendment is to require a Prescribed Pediatric Extended Case Center (PPECC) to provide transportation to a recipient when the recipient’s physician determines the recipient is stable to receive transportation services and the parent or legal guardian wants the recipient to receive transportation services.
