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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 for Clinic Services addresses the compliance concerns raised in the February 24, 2023 companion letter, for an April 1, 2023, effective date.
Summary: This SPA makes permanent telehealth flexibilities for home health services and to expand qualified providers to conform with federal regulatory changes.
Summary: This amendment will carve out basic life support and advanced life support ambulance transportation as well as nonemergency medical transportation (NEMT) services for nursing facility residents from the fee-for-service Medicaid NEMT brokerage.
Summary: This SPA proposes to modify language on the excluded drug coverage pages to reflect coverage of selective medications by referencing the state’s webpage resources instead of listing specific covered medications.
Summary: This SPA proposes to update the language on the state’s excluded drug list, including provisions for coverage of select over-the-counter (OTC) drugs.
Summary: This amendment makes changes to the Medicaid State Plan to allow for pharmacist reimbursement for services and prescriptions of hormonal contraceptive patches and self-administered hormonal contraceptives to eligible Medicaid recipients.
Summary: This amendment increased reimbursement for targeted case management, and replaces the phrase “mental retardation and other developmental disabilities” with the phrase “intellectual or developmental disabilities” on the submitted pages.
Summary: This amendment is to update the coverage provisions concerning extended services for pregnant women to align with the expansion of post-partum coverage approved in SPA 22-0008.
