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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 extends outpatient psychiatric care as a physician service through video telemental health technologies for eligible individuals in designated rural areas.
Summary: This SPA transmitted an amendment to your approved Title XIX State Plan regarding outpatient hospital reimbursements. Specifically, this SPA makes two technical changes to the State Plan: (1) to alter the data sources used to estimate prospective payments and (2) to correct the placement of language describing payment to hospital-based physicians which applies to both critical and non-critical access acute care hospitals.
Summary: Revises the application of sanctions and depreciation recapture. Revises the calculation of the direct care component to that it is based on resident-specific RUG rates.
Summary: Prohibits payments for items or services provided under the Medicaid State Plan or under a Medicaid Waiver to any financial institution or entity located outside of the U.S.
Summary: This SPA allows the State to establish programs to contract with one or more Medicaid Recovery Audit Contractors (RAC), in accordance with Section 6411 of the Affordable Care Act. The purpose of the Medicaid RAC is to identify overpayments and underpayments to recoup overpayments under the State Plan and under any waiver of the State Plan.
Summary: This SPA ensures compliance with the consultation requirements of Section 5006( e) of the American Recovery and Reinvestment Act. In Marylands case, it requires consultation with the one Urban Indian Organization (UIO) in the State, on Medicaid and Childrens Health Insurance Program SPAs, proposed waivers, waiver extensions, waiver amendments, and waiver renewals having a direct impact on Indians, Indian health programs, and/or UIOs.
Summary: This SPA, in accordance with Section 115 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPP A), exempts from the Medicaid estate recovery process the Medicare cost sharing benefits paid by the Medicaid program under the Medicare Savings Program for categories of Medicare and Medicaid dual eligibles aged 55 and older, with dates of service on or after January 1, 2010.
