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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: To establish a targeted case management benefit for Medicaid eligible pregnant and post-partum individuals who are in the Drug Free Moms and Babies (DFMB) program.
Summary: The SPA amends the preventative services benefit to allow dentists to also order community health worker services, clarifies what services are considered non-covered, and updates the community health worker ce1iification criteria.
Summary: Proposes to revise the State Plan to include routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials, including those beneficiaries enrolled in Alternative Benefit Plans, pursuant to the Center for Medicaid and CHIP Services requirements.
Summary: To temporarily extend Medicaid coverage of services to pregnant women for 12 months postpartum in accordance with section 9812 of the American Rescue Plan.
Summary: This SPA proposes to add routine patient costs associated with participation in qualifying clinical trials as a Medi-Cal benefit effective July 1, 2022 to comply with the Consolidated Appropriations Act of 2021, which amended the Social Security Act to add a new section 1905(gg) to cover this item.
Summary: This amendment is to expand the list of providers who can prescribe physical therapy to include physicians and other licensed practitioners of the healing arts within their scope of practice under state law, as authorized by federal regulations.
