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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: Effective July 1, 2020, this amendment increases the number of FTEs for the states Graduate Medical Education (GME) program which will provide access to care in more rural areas of the state. Both public and private hospitals will be allowed to participate.
Summary: Effective January 1, 2021, this amendment allows the Division of Medicaid (DOM) to remove the list of specific Current Dental Terminology (CDT) codes.
Summary: Creates a Family Planning Presumptive Eligibility (FPE) Program to enroll participants in a temporary eligibility group to receive family planning services. Participants enroll at Family Planning Qualified Entities (FPEQEs), which are Maryland Family Planning Program Delegate Service Sites enrolled in Medicaid that are in good standing. The goal of FPE is to provide a pathway to longer-term Family Planning Program coverage by allowing participants to have timely access to family planning health care services through an on-site, temporary eligibility determination.
Summary: Technical correction to restore the limits on physical, occupational and speech therapy for Medically Needy individuals 21 years of age or older.
Summary: Effective January 1, 2021, this amendment changes the methodology and thresholds for determining cost-effectiveness for Medicaid Estate Recovery and clarifies the definition of "recoverable medical assistance."
Summary: This SPA incorporates the current version of the Program of All-Inclusive Care for the Elderly (PACE) State Plan Amendment preprint and provide State assurances that PACE rates are set at less than 100% of the amount that would otherwise have been paid for a comparable population.
Summary: Effective January 1, 2021, this amendment increases the local poverty level (LPL) such that the MAGI income standards of 138% of the LPL is equivalent to 150 percent of the federal poverty level (FPL).
