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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: Implements the Community First Choice (CFC) program under section 1915(k) of the Social Security Act. CFC services would be provided to individuals who meet categorical coverage requirements for Medicaid or meet financial eligibility for home and community-based services and who meet aninstitutional level of care.
Summary: This amendment proposes comprehensive changes to the reimbursement methodology for intermediate care facility for individuals with intellectual disability services from state owned and operated facilities.
Summary: This SPA will allow the state to use MAGI-based income methodologies for determining medically needy eligibility for pregnant women, children and caretaker relatives.
Summary: This SPA replaces the existing DRG classification system for inpatient hospital services with a more refined grouper that recognizes the differences in severity of illness - the 3M APR-DRG.
Summary: This SPA allows individuals, with income between 101-133% of FPL, who use to be mandated into the MarketPlace plan to elect enrolling in the Health and Wellness Plan.
