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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: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend certain COVID-19 disaster relief policies originally approved in Disaster Relief SPAs IL-20-0004, IL-20-0013, IL-21-0004, IL-21-0005, and IL-23-0016. This amendment also proposes to add a new Section 7.4.C to temporarily increase the asset test to $17,500 for Medicaid beneficiaries determined eligible through the Aged, Blind, and Disabled category.
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 SPA approves a template that will authorize the state to enter in Value/Outcomes-Based Agreements with drug manufacturers for drugs provided under the Medicaid program.
Summary: The purpose of this SPA is to remove 1932(a) pages originally used for the State’s Medicare-Medicaid Alignment Initiative from the State Plan. These pages are no longer needed because CMS’ review and approval of the State’s managed care contract under 1915(a) authority will be used for this voluntary Medicaid managed care program.
Summary: This SPA elects the Individuals Eligible for Family Planning Services (“Family Planning”) eligibility group and elect to add Presumptive Eligibility (PE) for the Family Planning eligibility group.
