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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: Effective January 1, 2017, this amendment revises reimbursement for inpatient hospital services. Specifically, it provides additional payments to specialty, critical access and physical medical rehabilitation hospitals to account for increases in the minimum wage (MW).
Summary: Effective April 1, 2021, this amendment adds Electronic Visit Verification (EVV) compliance language and make technical language changes to update personal care benefits under the state plan. There are no changes to services and no impact to beneficiaries.
Summary: Effective January 01, 2021, this amendment removes an incorrect acronym used in describing the provider qualifications for the Individual Intensive Supports service. The change does not alter the provider qualifications themselves.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add pharmacy interns and techs to the providers who can administer vaccines. It also notes that the State will follow current vaccine administration reimbursement methodology for interns and techs, paying $14.15 per vaccine administration.
Summary: Effective March 1, 2021, this amendment updates the early and periodic screening, diagnostic, and treatment (EPSDT) fee schedule to add reimbursement rates for cranial remolding helmets.
