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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: Effective October 1, 2020 until September 30, 2025; pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Summary: Effective January 1, 2021, this amendment updates the State Supplementary Payment levels for the "Optional State Supplement Beneficiaries" eligibility group.
Summary: update the benchmark plan for the ABP for the New Adult Group. This is being updated to a 2014 base benchmark plan pursuant to 45 CFR §156.110. The ABP delivery model summary is also being updated based on the approved 1115 Global Commitment to Health waiver. This SPA was approved June 10, 2021 with an effective date of January 1, 2017.
Summary: Effective January 1, 2021, this amendment expands the provider types that can authorize home health plans of care and order durable medical equipment.
Summary: Effective January 1, 2021, this amendment decreases select Durable Medical Equipment (DME)/ Disposable Medical Supplies (DMS) codes from 85 percent to 80 percent of the current Medicare rates while clarifying payment for DME/DMS where no Medicare fee exists.
