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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 clarified Rural Health Clinic (RHC) encounter limitations and exceptions, clarified the provision of "other ambulatory services," and identified provider types and qualifications of who may provide RHC services.
Summary: This SPA clarified Federally Qualified Health Center (FQHC) encounter limitations and exceptions, clarified the provision of "other ambulatory services," and identified provider types and qualifications of who may provide FQHC services.
Summary: Allows State to Add New Managed Care Contractors When Needed, to Allow for Integrated Healthcare Delivery in Select Areas of the State, and to Update the Pre-Print To Its Most Recent Version.
Summary: Amends the Alternative Benefit Package for the new adult expansion group to account for programmatic changes made to the State Plan in 2015, subsequent to its original approval including services provided through the Community First Choice State Plan Option approved in WA-15-0012.
Summary: This SPA adds information for preventative dental services for children age 20 and under that was inadvertently removed from the Medicaid state plan.