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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 amendment updates inpatient acute hospital payment methods and standards. The amendment also authorizes supplemental payment to qualifying acute hospitals and establish payment rates for new behavioral health and substance abuse use disorder services rendered in the hospital. Additionally, this amendment sunsets the state's pay-for -performance program but continue new incentive payment previously approved under the stat's clinical quality incentive program and its hospital quality and equity incentive program.
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.
Summary: This SPA implements coverage of the Advisory Committee on Immunization Practices' recommended vaccines for adult Medicaid beneficiaries without cost sharing, in compliance with Section 11405 of the Inflation Reduction Act of 2022.
