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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: 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: To update the pharmacy coverage section of the state plan to align with requirements of Section 175 of the Medicare Improvement for Patients and Providers Act of 2008.
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.
Summary: The purpose of this SPA is to amend the State's approved Title XIX State Plan to update the state's Preadmission Screening and Annual Resident Review (PASRR) methodology to align it with the state's PASRR manual. This SPA is cost neutral.
Summary: Updates the Non-Emergency Medical Transportation Services section of the state plan to be consistent with the State's approved 1915 (b) waiver for NEMT services.
Summary: Includes reimbursement for the originating site facilities, telemonitoring of a patient in their home and for interprofessional telephone and internet assessment and management services provided by a consultative physician.
