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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 amendment is to clarify existing policy for preventive services regarding mandatory coverage requirements for approved adult vaccines to comply with CMS guidance in State Health Official (SHO) Letter 23-0003.
Summary: Renews the rate setting methodology for freestanding skilled nursing facilities Level -B (FS/NF-B) and freestanding adult subacute facilities (FSSA) and provides a 2.4 percent increase in statewide weighted average Medi-Cal reimbursement rate for FS/NF-B and FSSA facilities
Summary: This amendment proposes to align the Alternative Benefit Plan (ABP) with the Medicaid state plan by clarifying the benefit descriptions for cardiovascular and pulmonary rehabilitation services.
Summary: This amendment aligns the Alternative Benefit Plan (ABP) with the Medicaid state plan by adding Diabetes Prevention Program (DPP) services for adults ages 18 years and older who meet certain federal Centers for Disease Control and Prevention (CDC) Diabetes Prevention Recognition Program (DPRP) eligibility criteria.
Summary: This amendment is to update the coverage provisions concerning extended services for pregnant women to align with the expansion of post-partum coverage approved in SPA 22-0008.
Summary: Effective July 1, 2023, this amendment extends the Non-Designated Public Hospital Supplemental Fund program for the state fiscal year ending 2024.
