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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 is to include pharmacists as a recognized practitioner type allowed to charge for services given to Medicaid clients under Attachment 3.1-A, Section 6.d. and Attachment 4.19-B, Section 6.d of the state plan.
Summary: This State Plan Amendment is an exemption of the State’s requirement to contract with a Medicaid Recovery Audit Contractor. This is a time-limited SPA with an expiration date of July 1, 2025. This is a period not to exceed two (2) years.
Summary: This amendment is to add School-Based Services, which allows the State Medicaid Agency to reimburse local education agencies (LEAs) for providing health related services to Medicaid eligible students in a school-based setting.
Summary: This amendment is to comply with mandatory Medicaid coverage of routine patient costs furnished in connection with participation in qualifying clinical trials.
Summary: Applies a census income disregard to the Medicare Savings Programs (MSPs) and to migrate eligibility requirements already approved for MSPs under the existing state plan.
