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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 (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind rates approved in DR SPA 20-0008 effective 1/1/21.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to establish a new threshold for determining when to seek recovery of reimbursement from a liable third party for COVID-19 testing and associated laboratory services administered through public health agencies.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to add a temporary 5% nursing home rate eff 4/1/21 through 6/30/21. It also makes additional rate add-ons for pediatric inpatient psych services effective from June 1, 2021 through June 30, 2022, rate add-on for hospitals that increase pediatric inpatient psychiatric bed days by at least 10% or 2 beds compared with the same quarter in 2019, whichever is greater and effective July 1, 2021 through June 30, 2022 a rate add-on for pediatric inpatient psychiatric bed days provided to each child whose behavior demonstrates acuity that requires additional support on the inpatient unit and is sufficiently acute that it interferes with therapeutic participation.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement payments to outpatient hospitals for providing specimen collection for COVID-19 tests when no other service is provided to that beneficiary on the same date by that hospital at 100% of the Medicare rate on Addendum B.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement the provider retainer payments identified in Section E of this state plan amendment (SPA) from April 1, 2020 through April 30, 2020.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to authorize a new payment method for Federally Qualified Health Centers and Rural Health Clinics, adjusts the RBRVS conversion factor used to set payment rates for professional services, and modifies requirements for private duty nursing services.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to effective April 1, 2021, add single case agreement language to inpatient hospital out of state provider payment methodology. Effective July 1, 2021, it also adds reimbursement for Crisis Assessment services conducted after hours.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to enable the State to receive federal Medicaid matching funds for fee-for-service COVID-19-related supplemental payments to Small Rural Disproportionate Share Hospitals (SRDSH).
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to establish coverage of prescribed drugs that are not covered outpatient drugs, including when the drug is authorized for import into the United States by the FDA, when the state determines coverage is medically necessary due to a recognized critical drug shortage.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a Direct Service Workers recruitment and retention bonus provision under 9817 American Rescue Plan Act of 2021.
