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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: 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: 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.
Summary: This amendment allows the District to update the state’s excluded drug listing; to provide coverage for select agents for the treatment of infertility; to enter in Outcome-based arrangements with manufacturers; and to increase flexibility to improve access to prescription and over-the-counter drugs.
Summary: This amendment will allow Licensed Marriage and Family Therapists (LMFT) and LMFT Licensure Candidates in training to provide services as qualified behavioral health clinicians for covered rehabilitative services.
Summary: 1) to supply assurances that it is complying with new third party liability requirements authorized under the Consolidated Appropriations Act, 2022 and 2) to provide clarity on the state’s option to adopt a new flexibility on creating liens for injury settlement proceeds attributable to future medical expenses.
Summary: This amendment adopts version 40 of the APR-DRG grouper, which updates the relative weight values, and average national length of stay (ALOS).
