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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 removes State Plan language that allows for the Children's Outpatient Hospital Adjuster Pool to be funded as a Title XIX/Medicaid payment. The payment has been converted to a Title XXI/Childrens Health Insurance Program (CHIP) funded payment.
Summary: This SPA implements the use of an alternative payment methodology (APM) to reimburse Federally Qualified Health Centers (FQHCs) for medical and dental services.
Summary: Provides for an exemption from estate recovery in an amount equal to the benefits paid by certain LTC insurance policies, where those benefits were disregarded in the determination of an individual's Medicaid eligibility.
Summary: This amendment proposed a removal of the optional coverage of benzodiazepines, barbiturates and smoking cessation medications from the excludable drug category.
Summary: This SPA is being submitted to comply with Section 2301 of the Affordable Care Act which requires states that recognize freestanding birth centers, and the services rendered by certain other professionals providing services in a freestanding birth center to cover the services provided by those centers and professionals as mandatory Medicaid services eligible for FFP.
Summary: Provides Breast and Cervical Cancer Coverage for the Uninsured Individuals Diagnosed at the Center for Disease Control and Preventation Breast and Cervical Cancer Early Detection Program.
Summary: This SPA proposes to change the service limits for comprehensive tobacco cessation services provided to pregnant women, including both counseling and pharmacotherapy, without cost sharing.
