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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: SPA Implements the CAP for dental services received in a clinical setting. Diagnostic, preventive, emergent, anesthesia in conjunction with allowable oral surgery procedures and fabrication of denture services are excluded procedures.
Summary: Allows the state to provide alternative therapies for the management of chronic pain by using medical alternative therapy and non-opioid pharmacologic therapy for adults participants.
Summary: Revises the Ambulatory Surgical Center fee schedule. Adds HCPCS code 41899 (Unlisted procedure, dentoalveolar) to the Ambulatory Surgical Center fee schedule, to expand access to dental care.