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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 proposed to update the dispensing fee for preferred brand name and generic drugs as well as generic drugs not identified on the preferred list from $6. 52 to $6.65.
Summary: This SPA updates a change in language in Home HealthServices to further clarify the coverage limitations on diapers and to reference the correct entity that conducts reviews for medical necessity and for prior authorizations.
Summary: This amendment updates the payment pool amount for graduate medical education GME supplemental payments and provides for other minor clarifications.
Summary: Implements legislative funding for nursing facility reimbursement, Updates references to reflect the current fiscal year, Updates the current Statewide median price and incorporates the funding level for the direct care wage component of the rate and provides for other minor clarifications.
Summary: Amend Personal Care Services to incorporate reimbursement methodology for direct care worker wage supplemental funding and health insurance for health care worker funding for PCS providers.
