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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 amendment proposes to allow Medicaid-enrolled pharmacists to bill Maryland Medicaid for professional services rendered within their lawful scope of practice.
Summary: This amendment proposes to implement premiums for working adults who have disabilities as authorized by the Ticket to Work and Work Incentives Improvement Act.
Summary: Cover adult vaccine administration in accordance with Advisory Committee on Immunization Practices (ACIP) recommendations, in compliance with guidance on mandatory vaccine coverage and administration for adults in alignment with ACIP.
Summary: This amendment proposes to provide coverage of all approved vaccines recommended by the Advisory Committee on Immunization Practices and vaccine administration when furnished by a qualified provider.
Summary: This amendment proposes to update the preventive services to align with the United States Preventive Services Task Force recommendations for preventive screening services and the Advisory Committee on Immunization Practices recommendations for immunizations. Additionally, this amendment proposes to include the current reimbursement methodology for vaccines for both children and adults under the Preventive Services section of the State Plan. This amendment also proposes to remove the limits previously applied to the ambulatory care annual visits.
Summary: Adds an assurance that the Department of Medical Assistance Services will make coverage and billing code modifications when the Advisory Committee on Immunization Practices (ACIP) and/or U.S. Preventive Services Task Force (USPSTF) “A” and “B” recommendations change. The amendment also makes a technical change to revise reference to section “4016” of the Patient Protection and Affordable Care Act to section “4106.”
Summary: DESCRIPTION: Proposes several changes to update, clarify, and streamline language in the state plan. The proposed changes include: 1) streamlining language that describes certain therapy modalities, which are available under the Counseling/Therapy service benefit, 2) updating supervision requirements for behavioral health providers in Federally Qualified Health Centers (consistent with District Law), 3) clarifying education and experience requirements for credentialed staff able to provide State Plan rehabilitative services, and 4) updating rates for select behavioral health services according to the fee schedule.
