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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 SPA is to update pages for Nurse Practitioner Services in response to CMS Companion Letter to Marylands SPA 13-02; amending language associated with medical necessity criteria.
Summary: This amendment is an administrative correction for an error resulting from submission and approval ofMD ll-14A. Specifically, MD 13-13 re-establishes reimbursement language for residential treatment centers.
Summary: Updates the medical review process for determining that a person cannot reasonably be expected to be discharged and return home, and to update Form 4246.
Summary: Suspends the annual inflation factor applied to inpatient hospital and nursing facility (including intermediate care facility for individuals with intellectual disabilities) rates for the state fiscalyear ending June 30, 2013.
Summary: Reimburses physicians who self-attest to a primary care designation of internal medicine, family medicine or pediatric or a physician that has a practice history of primary care as represented by a 60% claims history for approved E&M reimbursement codes for services rendered in calendar year 2013 and 2014. In addition, the State will pay the federally calculated VFC vaccine administration charge.
Summary: Reimburses certain providers at the statewide rate which reflects the Medicare mean value over all counties for E&M codes 99201-99499 for dates of services between January 1, 2013 and December 30, 2014.
