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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 plan amendment updates the payment eligibility criteria for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) that are eligible for the Alternative Payment Methodology (APM).
Summary: This plan amendment proposes updates the payment methodology for Community Health Workers (CHWs) under Federally Qualified Health Centers and Rural Health Clinics.
Summary: Provides authority to cover targeted case management services for Children’s Special Health Care Services (CSHCS) beneficiaries under 21 years of age with qualifying medical complexity.
Summary: Covers targeted case management for children, youth, and young adults ages 0-21 with either a serious mental illness (SMI), serious emotional disturbance (SED), or intellectual/developmental disability (I/DD), and their families.
Summary: This plan amendment proposes to provide a 2.84% COLA for OASAS freestanding outpatient services, Part 820 residential services, freestanding residential medically supervised withdrawal, and freestanding residential rehabilitation.
Summary: Recognizes the shift to require managed care plans to cover transportation to all Medicaid-covered services, clarifies coverage language, and reflects other technical adjustments.
Summary: This plan amendment continues supplemental upper payment limit payments to state publicly owned and operated inpatient hospitals for state fiscal year 2022 in the amount of $24,622,791.
