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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 SPA is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This plan amendment extends enhanced payments to private Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), in order to allow more time to address the needs of private ICF/IID that still rely on this variance while continuing to provide services to the residents of these facilities.
Summary: Changes to the early and periodic screening, diagnostic and treatment benefits, and related payment methodologies. The proposed changes align payments for direct medical services, which are outlined in an individualized education plan and supplied in a school-based setting, to actual costs for providing these services.
Summary: This amendment revises the distribution of Graduate Medical Education (GME) and Indirect Medical Education (IME) payments for State Fiscal Year 2025.
Summary: This amendment revises the distribution of Graduate Medical Education (GME) and Indirect Medical Education (IME) supplemental payments for the State Fiscal Year 2025.
Summary: This amendment amends provisions governing behavioral health services to expand the eligible individuals who can supervise Peer Support Specialists (PSS).
Summary: This plan amendment updates the provisions governing qualifying criteria and reimbursement methodology for other rural hospitals in order to increase payments for inpatient hospital services.
