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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: Personal Care Services Limitations on amount duration and scope and methods and standards of establishing payment rates for other types of care.
Summary: Clarifies the methodology by which transportation benefits will be provided including coverage for escorts; detail when prior authorization is required and establishes a payment methodology for such services.
Summary: Clarifies coverage provisions, including but not limited to prior authorization requirements in the areas of EPSDT services, FFQHC services, laboratory and x-ray services, family planning services, dentures, and prosthetic devices.
Summary: Clarifies coverage provisions, including but not limited to prior authorization requirements in the areas of EPSDT services, FFQHC services, laboratory and x-ray services, family planning services, dentures, and prosthetic devices.