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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: implement programmatic changes and reimbursement rates for the following: multisystemic therapy, functional family therapy, crisis intervention services, crisis stabilization services, and behavioral therapy
Summary: Removal of Outdated Substance Use Disorder, Behavioral Health, and Intellectual Disability (formerly, “Mental Retardation”) Case Management Utilization Review Language.
Summary: Increases rates for skilled and private duty nursing, and allows for overtime and sick leave for providers of consumer-directed care under certain circumstances.
Summary: Expands the substance use disorder service called “Preferred Office-Based Opioid Treatment” which has been available only to individuals with a primary diagnosis of opioid use disorder to individuals with a substance-related or addictive disorder.
Summary: Repeal of 3.5% rate reduction to reimbursement for hospital services effective with inpatient admissions and outpatient services on or after July 1, 2021.
