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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: Updates property values for undue hardship definition and cost effectiveness methodology. Revisions have also been made to the undue hardship criteria by increasing the amount of assets for a qualified undue hardship applicant or related family member.
Summary: This amendment allows new providers time to obtain their accreditation through an approved accreditation organization thereby increasing access to services.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to waive signature requirements for the dispensing of prescription drugs during the COVID-19 Public Health Emergency.
Summary: This amendment proposes to provide services to identified recipients under age 21 to improve family functioning by clinically stabilizing the living arrangement, promoting reunification, or preventing the utilization of out-of-home therapeutic venues (i.e., psychiatric hospitals, psychiatric residential treatment facilities, or residential treatment services).
Summary: This SPA proposes to add prior authorization information on preferred and non-preferred drugs, as well as for High-Investment Carve-Out drugs when delivered in the inpatient setting.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow for a professional dispensing fee to be reimbursed no more than every 14-days per individual "medication strength".
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to waive the signature requirements for prescription drugs during the COVID Public Health Emergency from 3/1/20 through 9/1/22.
Summary: This State Plan Amendment is an exemption of the State’s requirement to contract with a Medicaid Recovery Audit Contractor. This is a time-limited SPA with an expiration date of July 1, 2025. This is a period not to exceed two (2) years.
