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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: Amends the Alternative Benefit Plan to partially restore dental benefits for non-pregnant adults, restore coverage of dentures and crowns for adults and more frequently covered scaling and root planning for adults.
Summary: Non-Financial Eligibility-State Residency for Title IV-E Foster Care children. Lays out the residency authority for enrolling new and maintaining existing Title IV-E Foster Care children.
Summary: This amendment will permanently extend existing provider increases for certain primary care services provided by qualified physicians. In addition, this SPA would extend the rate increase for the same services when provided by psychiatrists, obstetricians/gynecologists, and advanced practice registered nurses.
Summary: This amendment will provide supplemental payments to eligible hospitals located within the District of Columbia that participate in the Medicaid program.
Summary: This SPA changes the retroactive effective date of eligibility for all eligibility groups except Qualified Medicare Beneficiaries from the date of eligibility/application to the first day of the month of eligibility/application under the Medicaid State plan.
Summary: Changes the effective date of eligibility for all eligibility groups except Qualified Medicare Beneficiaries from the date of eligibility/application to the first day of the month of eligibility application under the Medicaid State plan.
Summary: This State plan amendment (SPA), OR 15-0005, supersedes OR 13-0015, which was approved on April 8, 2015, except for the AG certification and the organizational chart. The approval package for OR 15-0005 includes A1-A3 (8 pages). OR 15-0005 supersedes the following OR-13-0015 pages: A1-A3 (9 pages). However, the AG certification and the organizational chart approved in OR-13-0015 remain in effect.