An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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 expands PE to include the Parents and other Caretaker Relatives, Former Foster Care and Breast
and Cervical Cancer groups, in addition to Children and Pregnant Women, and to allow the state-designated Qualified Entities to complete PE determinations for all groups covered in PE.
Summary: This SPA proposes to change the state’s multi-state Supplemental Rebate Agreement arrangement from being with National Medicaid Pooling Initiative (NMPI) to joining the Sovereign States Drug Consortium (SSDC). The SPA also proposes to allow the state to enter into individual Supplemental Rebate Agreements directly with manufacturers.
Summary: This SPA proposes to modify language on the Pharmacy coverage pages to reflect coverage of selective non-prescription (over-the-counter) medications, as well as removing language regarding coverage of cosmetic and hair growth agents from the excluded drug list.
Summary: The SPA increases the DMEPOS reimbursement rates to 80% of Medicare. The SPA will also add self-monitoring blood pressure (BP) devices to the DME list for pregnant women at risk for gestational hypertension, and for persons with heart failure or end-stage renal disease (ESRD).
