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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 SPA amends the current Targeted Case Management State Plan Amendment for Public Health Nurse Home Visiting to include 3 additional counties.
Summary: allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.
Summary: Adopt provisions governing medication-assisted opioid use disorder (OUD) treatment in opioid treatment programs, for Medicaid-eligible recipients ages 18 and over, diagnosed with OUD
Summary: Adds facilities to which originating site fees can be paid, specifically Federally Qualified Health Centers and School Based Wellness Centers, for telemedicine services
Summary: Authorizes 100% FFP for services provided by non-IHS/Tribal providers to Medicaid-eligible individuals who are Tribal Medicaid beneficiaries when the provider has a written care coordination agreement with an IHS/Tribal facility.
Summary: Restores coverage for certain optional benefits such as optometric and opticians’ services, audiology services, speech therapy services, podiatric services and incontinence creams and washes. This SPA also removes the monthly two-visit limit for services by podiatrists.
