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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 increase the physical, occupational, and speech therapy limit for children from eight to 30 visits per year, which can be exceeded with prior authorization.
Summary: This amendment is to update the Alternative Benefit Plan (ABP) to expand coverage for naturopath services and behavioral health clinician services.
Summary: This amendment proposes to provide a comprehensive adult dental benefit that includes diagnostic, preventive, limited periodontal, restorative, and oral surgery services for all Medicaid eligible adults age 21 and older within the Alternative Benefit Plan.
Summary: This amendment updates the alternative benefit plan to include coverage requirements for routine patient costs associated with participation in clinical trials and extends the prescription drug supply limit from thirty (30) days to ninety (90) days for the Health Indiana Plan (HIP) Basic group.
Summary: This amendment updates the alternative benefit plan to include coverage requirements for routine patient costs associated with participation in clinical trials for the Healthy Indiana Plan (HIP) Plus group.
Summary: Aligns Michigan’s Alternative Benefit Plan with the changes to prior authorization requirements for non-routine therapy services provided to beneficiaries residing in nursing facilities approved in the traditional Medicaid State Plan under MI-22-0017.
Summary: This amendment updates the Alternative Benefit Plan (ABP) pages to align with the addition of the mandatory benefit that covers routine patient costs associated with participation in qualifying clinical trials approved in SPA 22-0004.
Summary: This Alternative Benefit Plan (ABP) is to amend the State Plan to account for the change in managed care organization for Medicaid Expansion members between ages 21 - 64.