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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 1, 2021, this amendment increases dental rates for services provided by dental practice plans operated by publicly funded academic medical centers.
Summary: Effective October 1, 2019, this amendment allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
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 allow diagnosis and antibody testing in non-office settings (e.g., parking lots); to allow laboratory processing of self-collected diagnostic and antibody systems that the FDA has authorized for home use, and to provide enhanced rates to COVID-19 designated facilities for isolation and quarantine services and ventilator services.
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 The purpose of this amendment is to rescind the 20% IDF/ID increase authorized in superseded DR SPA.
Summary: This SPA proposes to allow coverage for select maintenance drugs for up to 90 days for Medicaid members after the end of the federal emergency period.
Summary: This amendment establishes an additional disporportionate share hospital payment to non-state government owned acute care hospitals and applies nursing facility inflation rates to specialized care facilities.
Summary: increases the rates for agency and consumer directed personal care, respite and companion services for early periodic screening and diagnosis and treatment program by five percent.
Summary: The purpose of this SPA is to update the ARTS state plan pages to incorporate general updates to the program, including updates related to medication assisted treatment, defining the scope of practice for certified substance abuse counselors, including substance use disorder counseling within that scope, and guidance related to telemedicine requirements.