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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 establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
Summary: Provides authority for coverage and payment of targeted case management for individuals age 18 and older who meet Medicaid eligibility requirements, have a chronic or complex physical or behavioral health need, and were recently incarcerated.
Summary: Aligns Michigan’s Alternative Benefit Plan with the changes to prior authorization requirements for non-routine therapy services provided to beneficiaries residing in nursing facilities approved in the traditional Medicaid State Plan under MI-22-0017.
Summary: This amendment proposes a change to the prior authorization requirements for non-routine therapy services provided to beneficiaries residing in nursing facilities.
Summary: Effective October 1, 2022, this amendment adds reimbursement methodology to Attachment 4.19-D of the state plan for off-island nursing facility services.
Summary: updates language to reflect the adoption of the American Academy of Pediatric Dentistry Recommendations for Pediatric Oral Health Assessment, Preventive Services, and Anticipatory Guidance/ Counseling schedule as a dental-specific periodicity schedule for children up to age 21 under the EPSDT requirement defined in section 1905(r) of the Social Security Act.
