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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 proposes to change provider requirements for community mental health centers, adds coverage of prophylaxis under the state’s dental benefit, allows for 90-day coverage of maintenance medications, and adds weight loss drugs to the state’s prescription drug formulary.
Summary: This SPA proposes to expand the full continuum of substance use disorder care by increasing access to certain services to beneficiaries diagnosed with a substance use disorder.
Summary: CMS is approving the state’s request to amend its 1915(i) state plan home and community-based services (HCBS) benefit, transmittal number TN 21-00004.
Summary: Authorizes the department to establish provider specific rates for services provided by Psychiatric Residential Treatment Facilities (PRTFs). The amendment also removes outdated language
Summary: Revising the Community First Choice (K-Plan) option which increases the local case management benefit limit on assistive technology, implements an enhanced Foster Care model which would allow for some children with intellectual and developmental disabilities to be diverted from children's residential placement to less costly and restrictive placements, adds Support Technology where advanced supervision is necessary.
