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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 to amend the State Plan to include additional provider types for rehabilitative services and designates Licensed Professional Counselors as Other Licensed Practitioners
Summary: This amendment proposes to update the coverage criteria for home health services as well as medical social services and to increase the reimbursement rates for those services.
Summary: This SPA proposes to allow for certain medications to be filled in 90-day supplies. This is a change the state made during the COVID-19 Public Health Emergency (PHE) period, and this SPA seeks to extend the provision beyond the PHE timeframe.
Summary: CMS is approving this state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the increase to the the pharmacy dispensing fee that was approved in Section D.8 of DR SPA KS-20-0012.
Summary: his amendment establishes coverage and reimbursement for substance use services provided in outpatient and residential setting within the rehabilitative services category.
Summary: CMS is approving DE-19-0009 which amends the State Plan to allow Medicaid beneficiaries to request coverage from pharmacies of select FDA approved over-the-counter medications through an agreement with the Department of Public Health Medical Director for the purpose of generating a prescription and clarifies the coverage policy related to drugs indicated for the treatment of obesity.
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 waive state rule beneficiary signature requirements for outpatient Rx drug pickup/delivery from 4/4/20-5/20/21. Add a $500 add-on per ventilation bed day to chronic disease hospital per diem rate from 10/1/21-6/30/2022 and add COVID vaccination administration reimbursement for dentists 12/11/20 through the end of the PHE and for hygienists from 12/11/20-4/14/22.
Summary: This amendment adds Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) reimbursement rates for periodontal
maintenance and for the use of prefabricated porcelain and ceramic crowns on primary teeth, as well as for the repair of crowns on primary teeth. It also increases ESPDT pediatrician reimbursement rates.
