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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow for an additional $300 per day for nursing facility COVID relief effective March 13, 2020. The amount reflects an estimated fee-for-service portion from the beginning of the national emergency through the FFY September 30, 2021.
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 update the drug benefits in order to make an adjustment to the professional dispensing fee when medications are delivered to an individual's residence, make exception to the the Commonwealth's preferred drug list if drug shortages occur and automatic renewal for prior authorization without clinical review.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to add provider types and make payment rate changes for certain home and community based services.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to increase payment rates for Applied Behavioral Analysis, Certain Children and Behavioral Health Initiatives, Early Intervention, Psychologist service rates and SUD Clinic service rates.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow the face-to-face contact required by qualified providers of Early Intensive Development and Behavioral Intervention (EIDBI) services to occur via telehealth, which may include communication by telephone.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow for Lab and X-Ray testing orders services to be provided in non-office settings and to recognize pharmacists as other licensed practitioners for the purposes of COVID testing and vaccine administration. Payment for services provided by licensed pharmacists will be made to the affiliated billing provider.
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the cap for supplemental disproportionate hospital share (DHS) payments to qualifying hospital providers.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to waive all cost sharing for all beneficiaries, regardless of the ultimate diagnosis, for testing services and treatments for COVID-19, including vaccines, specialized equipment, and therapies.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, and remove language that requires Pediatric Day Healthcare Center (PDHC) closure in order for families to receive services in a residential setting.
