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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 plan amendment updates the reimbursement methodology for physician services to align payment for topical fluoride varnish with the applicable dental service reimbursement methodology.
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 add supplemental payments to several providers.
Summary: This amendment proposes to comply with Electronic Visit Verification System (EVV) requirements by January 1, 2023, in accordance with Section 12006 of the 21st Century CURES Act.
Summary: This plan amendment updates the reimbursement methodology for physician services,
family planning and supplies, nurse-midwife services, and nurse practitioner services to the lower
of provider charges or 72.4% of the current corresponding Medicare rate, updates the fee schedule
for those services not covered by Medicare, and removes outdated provisions related to the
Primary Care Case Management (PCCM) program.
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 provide add-on payments for services rendered by family planning agency providers.