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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 is to amend the provisions governing children’s and adult mental health services to expand the mental health professionals eligible to provide therapeutic services to include provisionally licensed professional counselors, provisionally licensed marriage and family therapists, and licensed master social workers.
Summary: This amendment proposes to update the description of physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders to align with 42 CFR 440.110. It will also add coverage for medically necessary audiological services for members with full benefits who are ages 21 years and older.
Summary: This amendment proposes to expand the scope of covered dental services that are available to individuals over age 21. Individuals over age 21 will receive the following medically necessary dental services: diagnostic, preventive, restorative, periodontal, prosthodontic, orthodontic, endodontic, emergency dental services, and oral surgery (inpatient and outpatient).
Summary: This amendment is to update the clinical trainees provider definition listed under Rehabilitative Mental Health Services, Targeted Case Management, Substance Use Disorder Treatment Services, Expanded Substance Use Disorder Treatment Services, and Medication-Assisted Treatment.
Summary: The SPA implements a 90-day grace period for behavior technicians to be covered under the other licensed practitioner Medicaid benefit while working to acquire the Registered Behavior Technician credential.