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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 allow pharmacists to screen individual patients for hormonal contraception and administer through a standing order.
Summary: This amendment proposes to consolidate Registered Nurse (RN) and Licensed Practical Nurse (LPN) services into one consolidated nursing service and revises policy for reimbursement to family members under the Early and Periodic Screening Diagnosis and Treatment (EPSDT) benefit.
Summary: This SPA implements the five-percent inflationary increase to the Health Home Per Member Per Month and Clinical outcome measure payment rates appropriated by its state legislature during the 2023 legislative session
Summary: This amendment inflationary increases appropriated by the state legislature and updates the Physician Administered Drug Payment Methodologies.
Summary: This amendment proposes to increase rates and service limits for two autism spectrum disorder (ASD) services and add two additional codes with service description to the ASD Services Manual.
Summary: The purpose of the amendment is to update the quality measures and associated weights for the health home quality incentive payment methodology. The updated methodology was reduced from ten weighted measures to seven. The total quality incentive payment pool for this disbursement remained the same
Summary: This amendment extends the supplemental payments for qualifying, private hospitals and nursing facilities for an additional state fiscal year.
Summary: This State Plan Amendment implements a 16% inflationary increase for Community Mental Health Centers and Substance Use Disorder Agencies appropriated by the state legislature.
