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: Allows the Division of Medicaid to add coverage of licensed pharmacists under the Other Licensed Practitioners (OLP) for vaccine administration.
Summary: This amendment proposes to allow the Division of Medicaid (DOM) to add language to include the cost avoidance of prenatal claims in compliance with the Bipartisan Budget Act of 2018, to update the language describing data exchanges with other agencies, add the process for providers to request an override of the third party liability edit and update the code reference to ICD-10-CM, effective October 1, 2020.
Summary: This plan amendment was submitted to increase the fee schedule rate to 100% of the Medicare urban ambulance fee schedule for emergency ground transportation services as well as add a mileage component for emergency transportation services.
Summary: Adds coverage and reimbursement of Private Duty Nursing (PDN) services and Personal Care Services (PSC) for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) eligible beneficiaries
Summary: allow the state to revise the Medicare fee schedule update frequency from quarterly to annually. It also proposes to reimburse physician-administered drugs at Wholesale Acquisition Cost (WAC) +0% if there is no Medicare Part B Drug Fee Schedule or Medicare Addendum B OPPS Fee Schedule rate available.
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 make interim payments based on FFS utilization only to the fourteen (14) CMHCs that have had a decline in utilization due to the COVID-19 pandemic.
Summary: Graduate Medical Education (GME) Payments are being submitted to allow the DIvision of Medicaid (DOM) to address calculations for GME payments for a hospital during a cap building period
