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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: Effective July 1, 2021, this amendment increases the annual maximum for the adult preventive dental benefit from $750 to $1,000 per state fiscal year; clarifies and updates the language for the allowable dental services for eligible adult beneficiaries; clarifies providers qualified to be reimbursed for delivery dental services; defines limitations and articulates reimbursement methodology for the allowable medical and surgical services for which a dentist may be reimbursed when delivered to eligible Medicaid beneficiaries.
Summary: This state plan amendment establishes an Alternative Benefit Plan to serve persons eligible for Medicaid under Section 1902(a)(10)(A)(VIII) of the Social Security Act. This plan will offer Prime benefits equal to the current State Plan benefits offered in the state.
Summary: This SPA is changing the annual dental benefit limit from $1,000 to $750.00 for adult clients (age 21 and older). Exemptions will be in place for dental services for emergencies, extensive special needs and ill clients, and dentures.
Summary: Proposes to make supplemental payments for dental services provided by practitioners employed by a public entity (University of Nebraska Medical Center, School of Dentistry).
