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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 amendment is to elect the option described in section 1902(e)(16) of the Social Security Act to provide 12 months of postpartum coverage to Medicaid-eligible pregnant individuals.
Summary: Effective May 30, 2023, this amendment provides for coverage and reimbursement for psychiatric residential treatment facility (PRTF) services.
Summary: This amendment for Clinic Services addresses the compliance concerns raised in the February 24, 2023 companion letter, for an April 1, 2023, effective date.
Summary: To remove the requirement of charging premiums on a sliding fee scale for participants to contribute to the cost of medical assistance for the TWWIIA BBA and Basic coverage groups.
Summary: This amendment is to add coverage and reimbursement for services provided by licensed podiatrists under the other licensed practitioner benefit.
Summary: This amendment is to update the requirements for Third Party Liability – Payment of Claims for Third Party Liability- Identifying Liable Resources.
Summary: The state adds the target group of 0 through age 5 and clarifies needs-based criteria language to the High-Risk Children with SED HCBS benefit.
