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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: Clarifies language for existing benefits, specifically as they relate to those under the age of 21. The amendment will align the Alternative Benefits Plan (ABP) with the changes to traditional Medicaid.
Summary: This amendment updates the recipient and provider qualifications for Target Case Management (TCM) for individuals with a behavioral health condition.
Summary: This amendment is to update the plan to broaden coverage of nursing services in schools by removing the requirement that nursing services be listed in an to Individualized Education Program (IEP), as well as amend the tobacco cessation counseling services to include that these services must be provided by a licensed practitioner.
Summary: This amendment is to extend the time frame for Targeted Case Management (TCM) for pregnant individuals receiving services after the end of their pregnancy to 12 months to align with the state’s extended eligibility coverage of 12 months post-partum for Medicaid-eligible pregnant individuals.
Summary: This amendment is to increase coverage of eyeglasses for individuals aged 21 and older to permit annual replacement that may be exceeded based on medical necessity.
Summary: This amendment is to increase the monetary limit for dental services coverage and removes a specified tooth restriction for certain restorative porcelain and ceramic substrate crowns for individuals aged 21 and older.
Summary: This amendment will allow Licensed Marriage and Family Therapists (LMFT) and LMFT Licensure Candidates in training to provide services as qualified behavioral health clinicians for covered rehabilitative services.
