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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 SPA extends a 5% reduction in Medicaid payments for Nursing Facility services and a 3% reduction in Medicaid payments for Intermediate Care Facilities for the Developmentally Disabled services. This SPA reduces the NF reduction at 3% and reduces the ICF/IID and CRF/DD reduction to 1%.
Summary: Allows hospitals in the state to determine eligibility presumptively under the option. And the state to allow Medicaid coverage for individuals determined presumptively eligible under this provision.
Summary: This amendment covers and reimburses all United States Preventive Services Task Force (USPSTF) grade A and B clinical preventive services and approved adult vaccines and their administration recommended by the Advisory Committee on Immunization Practices (ACIP), without costsharing; and establishes a one percentage point increase in federal medical assistance percentage (FMAP) for these service expenditures whether they are provided in fee-for-service (FFS), managed care or under an alternate benefit plan.
Summary: This SPA describes the methodology used by the State for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the State and described in 42 CFR §435.119.
Summary: 1915(i) State Plan Home and Community-Based Services (HCBS), Behavioral and Primary Healthcare Coordination Services; and IN.02.001 - Amendment to 1915(b)(4) waiver, Adult Mental Health Habilitation and Behavioral and Primary Healthcare Coordination Services
Summary: Conversion to from 209(b) to 1634 status, adoption of optional ABD category to 100% FPL, and implementation of income disregards for the Medicare Savings Program to increase QMB to 150% FPL, SLMB to 170% FPL, and QI to 185% FPL.
Summary: Removes the 20 mile radius restriction for telernedicine services provided by Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs), Community MentalHealth Centers (CMHCs) and critical access hospitals. Provides reimbursement for telehealth services to horne health agencies.
