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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 to amend the State Plan to include additional provider types for rehabilitative services and designates Licensed Professional Counselors as Other Licensed Practitioners
Summary: This amendment proposes to update the coverage criteria for home health services as well as medical social services and to increase the reimbursement rates for those services.
Summary: his amendment establishes coverage and reimbursement for substance use services provided in outpatient and residential setting within the rehabilitative services category.
Summary: This amendment adds Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) reimbursement rates for periodontal
maintenance and for the use of prefabricated porcelain and ceramic crowns on primary teeth, as well as for the repair of crowns on primary teeth. It also increases ESPDT pediatrician reimbursement rates.