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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: Updates the single state agency description and organizational charts in accordance with the Affordable Care Act under the Medicaid State Plan.
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: Updates payment methodology to reduce reimbursement for state specified, non-emergency use of the emergency department for in-state acute care non-critical access hospitals.
Summary: Clarifies the State's coverage of family planning and family planning related services to go along with SPA 15 026 which added the Family Planning eligibility option to the State Plan.
Summary: Adds the optional Medicaid eligibility group which provides coverage to women and men that is limited to family planning and family planning-related services under the state plan.
Summary: The purpose of this SPA is to amend the State's approved Title XIX State Plan to amend reimbursement and add criteria for consideration of a change in scope of services provided by Federally Qualified Health Centers and Rural Health Centers. This SPA is estimated to be cost neutral.
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.
