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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: The state submitted this SPA to align its ABP with previously approved SPAs 23-0017, 23-0023, and 23-0027 regarding dental therapists, podiatry services and prior authorization policies for prosthetic devices.
Summary: This SPA is to bring the state’s alternative benefit plan (ABP) into alignment with the state plan to allow injections for allergy desensitization without prior approval and add marriage and family therapists as a billable provider under federally qualified health centers (FQHCs) and rural health centers (RHCs), effective January 1, 2018.
Summary: This amendment proposes to update the Alternative Benefit Plan population, voluntary benefit package selection process and the process for exempting members from mandatory enrollment.
Summary: This Alternative Benefit Plan amendment is to add coverage and reimbursement of community violence prevention services performed by certified violence prevention professionals as a new benefit.
Summary: The amendment is to update the Standard Alternative Benefit Plan (ABP) to include Continuous Skilled Nursing services under the Private Nursing provider type.
Summary: This amendment adds mandatory coverage of routine patient costs in qualifying clinical trials per the Consolidated Appropriations Act of 2021 to the state's ABP.
