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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 plan amendment simplifies payment methodology for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) dispensed by a pharmacy.
Summary: This amendment is to amend its hospital presumptive eligibility SPA and presumptive eligibility program to include a performance standard for qualified entities or hospitals determining presumptive eligibility for pregnant women and/or children.
Summary: This plan amendment updates Medicaid reimbursement rates for physical therapy, occupational therapy, and speech-language therapy services under the home health benefit.
Summary: The District is seeking to sustain requests approved in their Temporary Extension to the Medicaid Disaster Relief COVID-19 National Emergency SPA #23-0004, which expires on May 11, 2024, by adding its language to the permanent Housing Supportive Services (HSS) 1915(i) Home and Community-Based Services SPA. If approved, this SPA will permit the HSS program to continue to utilize the appropriate determination and redetermination tools to ensure that District residents secure and maintain permanent supportive housing and to allow expanded provider qualifications for case manager supervisors.
Summary: We have reviewed the proposed amendment to Attachments 4.19-D of your Medicaid State plan submitted under transmittal number 24-0001 titled “Payment for Services: Nursing Facility Services - Ventilator Program.”
Summary: This plan amendment is adding Inter-professional Consultation and Collaborative Care Services under the District’s physician services benefit.
Summary: Provide a twelve (12) month continuous eligibility period to children under age nineteen, who no longer meet eligibility requirements. This SPA will align the District's eligibility and operational practices with new federal requirements set forth under the Consolidated Appropriations Act of 2023.
