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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 the state plan language to comply with amended section 1905(a)(30) of the Social Security Act, assuring coverage for routine patient costs of items and services for Medicaid beneficiaries
enrolled in qualifying clinical trials.
Summary: This plan amendment increased the daily rate for Assisted Living Facilities on average by two (2) percent. The weighted average increase is expected to be $1.70, though this amount will vary based on the Comprehensive Assessment Reporting Evaluation classification of each individual client.
Summary: This amendment allows the state to pay up to the higher allowed payment for services provided for psychiatric long-term civil commitments when the claim is for an allowed service(s) and paid for by both Medicare and Medicaid.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a one-time supplemental payment to community mental health providers for mental health and SUD services; non-institutional DMEPOS providers; and home health agencies for COVID-19 relief.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement one-time supplemental payments to nursing facility (NF), intermediate care facility (ICF), and hospice Medicaid providers for COVID-19 relief.
Summary: Adds that home health services must be ordered by a physician, physician assistant (PA), or advanced registered nurse practitioner (ARNP) as part of a written plan of care.
Summary: Authorizes the state to enter in Value-Based Purchasing (VBP) rebate agreements with drug manufacturers for drugs provided under the Medicaid program.