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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 proposes to allow for limitation on amount, duration and scope of medical care and services provided for prescribed drugs through value-based and supplemental
Summary: Effective March 1, 2021, this amendment implements the 1915 (1) State Plan Option that provides Medicaid Assistance for eligible individuals who are patients in eligible institutions for mental diseases (IMD) in accordance with Section 5052 of Public Law 115-271.
Summary: Limitations on amount, duration, and scope of Medical Care and Services provided to categorically and medically needy; methods and standards for establishing payment rates other types of care to include the covered service “Buprenorphine Enhanced Supportive Medication-Assisted Recovery and Treatment (BE-SMART)” for adults in addition to provider qualifications
Summary: Deletes the obsolete covered service “Community Mental Retardation Clinics” and add “Methadone Clinic Services” for adults as a covered service
Summary: Updates to the paper application, and the state’s election to use an alternative single, streamlined application developed by the state for individuals applying for coverage who may be eligible based on the applicable modified adjusted gross income standard
Summary: This SPA allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.
