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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 amendment is to conform the state plan to Section 210 of the Consolidated Appropriations Act, 2021 (Public Law 116-260) related to mandatory Medicaid coverage of routine patients costs furnished in connection with participation in qualifying clinical trials.
Summary: This SPA amends to implement changes to state law meant to further the use of telemedicine and telehealth by allowing the option to receive certain services using an audio-only platform.
Summary: Updates the Early and Periodic Screening, Diagnosis and Treatment, Prescribed Pediatric Extended Care Centers (PPECC) transportation rate to align with the Texas Health and Human Services Commission PPECC biennial fee review.
Summary: The SPA provides assurances that the State complies with federal requirements regarding coverage of routine patient care associated with participation in clinical trials as required by the Consolidated Appropriations Act, 2021.
Summary: revises the inpatient hospital services reimbursement pages of the State Plan to enhance clarity, modify the policy for updating the DRG statistical calculations, and add requirements for a biennial review of rural hospital rates.
