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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 10/01/2020, this amendment updates the reimbursement methodology for privately owned chronic disease and rehabilitation inpatient hospital services for fiscal year (FY) 2021.
Summary: Effective 10/01/2020 this amendment updates the reimbursement methodology for privately owned psychiatric and substance use treatment hospital services for fiscal year (FY) 2021.
Summary: Effective 10/01/2020, this amendment updates the methods and standards used to revise the payment rates for acute outpatient psychiatric and substance abuse outpatient hospitals.
Summary: Updates the fee schedule methodology for EPSDT, Home Pharmacy Services, Medical Supplies, and Dental services in response to a Companion Letter issued by CMS with the approval of SPA 19-0005
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to update Payment Methodologies for Certain Hospital, Community Health Centers, Physician, and coverage for mobile testing service done by EMTs during the COVID-19 Emergency period.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to pay a one time supplemental payments to chronic disease and rehabilitation inpatient hospitals.
Summary: This SPA seeks to confirm that the state covers all preventive services assigned a grade of A or B by the U.S. Preventive Services Task Force (USPSTF), and all approved adult vaccines and their administration recommended by the Advisory Committee on Immunization Practices (ACIP), without any cost-sharing in order to demonstrate compliance with Section 4106 of the Affordable Care Act.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to update payment methodologies for acute inpatient and psychiatric inpatient hospital services during the PHE.
