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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: Proposed amendment to your Agency's approved Title XIX State plan to (1) impose prior authorization requirements on high tech imaging, (2) limit the number of urine testing on a monthly basis; and (3) set limits and prior authorization requirements for physical, occupational and speech therapy services.
Summary: This SPA transmitted a proposed amendment to your approved Title XIX State plan to update coverage of targeted case management services provided to persons with developmental disabilities (1) who are unable to access needed medical, social, educational and other services because of adaptive deficits due to their level of disability, or (2) who lack the active assistance of a family member or other interested person to assist them in accessing needed services.
Summary: This amendment clarifies that hearing instrument specialist services are provided as other licensed practitioner services pursuant to 42 CFR 440.60 and updates the State plan to reflect the State's new hearing aid replacement policy.
Summary: Modifies citizenship documentation requirements to comply with the Deficit Reduction Act of 2005 and clarifies continuous Medicaid coverage for newborns.
Summary: Eliminates certain optional services and imposes limitations on other optional services for adults age 21 and older Specifically, this SPA eliminates podiatrists services preventive dental services and well and physical exams. This SPA also limits prosthetics coverage and organ transplantation Dental services also are limited to treatments of oral disease prior to transplantation and to extractions prior to treatment of certain cancers.
