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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 makes changes to the State Plan as a result of Section 4107 of the Affordable Care Act that amends section 1905 of the Social Securoity Act to require coverage of counseling and pharmacotherapy for cessation of tobacco use by pregnant women.
Summary: This amendment makes changes to the State plan to modify provider requirements during an audit, revise the related party definition and the requirement to receive a related party exception, and clarify the administrative reconsideration and appeals process.
Summary: This amendment proposes implementation of lead case management and enviromental lead investigation services for individuals who tested for elevated blood lead levels.
Summary: This amendment seeks to revise the reimbursement methodology of DM Medical Equipment and Hearing Aids as well as reduce the rates by 5% for services rendered between July 1, 2011 and June 30, 2011.
Summary: This amendment seeks to revise the state plan to add freestanding birthing renters and provide Medicaid coverage and reimbursement for services provided in those centers.
Summary: This amendment seeks to eliminate Targeted Case Management services for Individuals with HIV, Pregnant Woman, Persons Identified as Seriously Mentally Ill or Seriously Emotionally Disturbed, Low Functioning Severely and Persistently Mentally Ill Adults Needing Assertive Community Treatment (ACT), Individuals with Developmental Disabilities, and Case Management for. Elderly or Disabled Individuals Diverted/Deinstitutionalized from Nursing Facilities from the State Plan.
