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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 adds assurances that the state covers and reimburses COVID-19 vaccine administration, testing, and treatment as required under section 9811 of the American Rescue Plan Act of 2021.
Summary: This amendment adds optometry services to the state plan, revises coverage of eyeglasses/contact lens, and adds a fee-for-service payment methodology for these benefits.
Summary: This amendment was submitted in order to update the Medicaid fee schedule to include the rate increase for adaptive behavioral treatment by Behavioral Therapists.
Summary: The state proposes to include assurances that the state complies with Third Party Liability rules as authorized under both the Bipartisan Budget Act of 2018 and the Medicaid Services Investment and Accountability Act of 2019. The state has submitted this SPA per the guidance issued in August 2021. CMS supports this change.
Summary: To include assurances that the state covers routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries, who receive benefits through the alternative benefit plan, in qualifying clinical trials.
Summary: The state proposes to include an assurance that the state covers routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials.
Summary: Effective January 14, 2022, this amendment authorizes a one-time $30,000,000 supplemental Charity Care Subsidy Disproportionate Share Hospital (DSH) payment. Consequently, the total Charity Care Subsidy payments for state fiscal year (SFY) 2022 increases to $349,000,000.
