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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 proposes contracting with a Recovery Audit Contractor to identify underpayments and overpayments of Medicaid claims under the State Plan and any waiver of the State Plan.
Summary: Adds licensed professional counselors and licensed marriage and family therapists to the core services proved by Federally Qualified Health Centers and Rural Health Clinics. The amendment also added pharmacists and licensed dietician-nutritionists to the list of other ambulatory services offered by Federally Qualified Health Centers and Rural Health Clinics.
Summary: This amendment allows the Division of Medicaid to comply with the Inflation Reduction Act (IRA) requirement to attest to the coverage of all Advisory Committee on Immunization Practices recommended vaccines and their administration.
Summary: This amendment proposes coverage for all approved vaccines recommended by the Advisory Committee on Immunization Practices and vaccine administration when furnished by a qualified provider.
Summary: This amendment proposes to provide coverage of all approved vaccines recommended by the Advisory Committee on Immunization Practices and vaccine administration when furnished by a qualified provider.
Summary: This amendment proposes to update the preventive services to align with the United States Preventive Services Task Force recommendations for preventive screening services and the Advisory Committee on Immunization Practices recommendations for immunizations. Additionally, this amendment proposes to include the current reimbursement methodology for vaccines for both children and adults under the Preventive Services section of the State Plan. This amendment also proposes to remove the limits previously applied to the ambulatory care annual visits.
