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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 January 01, 2021, this amendment allows substance use disorder (SUD) agencies to be reimbursed an originating site fee for acting as a telemedicine originating site.
Summary: Effective June 1, 2021 until terminated on May 31, 2023, this amendment extends the exception to the Medicaid Recovery Audit Contractor (RAC) program.
Summary: Effective September 1, 2020, this amendment provides targeted rate increases for providers of mental health and behavioral health services, specifically individual psychotherapy, substance use assessment, and day rehabilitation services.
Summary: Effective 11/01/2019 this amendment clarifies that substance use disorder (SUD) early intervention services provided by a SUD agency are covered and SUD treatment services may be provided in an institution for mental disease (IMD).
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 establish an additional $20 per day payment per Medicaid beneficiary for nursing facilities effective from May 1, 2020 to December 31, 2020.
