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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 provides a 4% inflationary rate increase for Rural Health Clinics that enrolled as Medicaid providers before 12/31/12 to receive a one- time adjustment to their rate based on the 2013 Medicare cost report.
Summary: Update the levels of care for ambulatory behavioral health services with the American Society of Addiction Medicine (ASAM) and to update the annual limit of Medicaid-covered, outpatient ambulatory behavioral services.
Summary: This amendment updates the State plan to provide for a four percent inflationary rate increase for psychiatric residential treatment facilities (PRTFs).
Summary: This SPA adds limited orthotics coverage to halos, walking boots, and knee orthotics as part of the prosthetics benefit described in Attachment 3.1-A Limitations.
Summary: Conducts presumptive eligibility for individuals applying for coverage prior to January 1, 2014 and who needed coverage approved effective January 1 to ensure they had coverage in place.
Summary: Updates State Plan on Basic Organization and Administration of Medicaid Program and Includes Information on Agency's Delegation of Appeals and Determinations.
