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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: Updates reimbursement rates, when applicable, and increase reimbursement rates for restorative dental se1vices five percent (5%) above the previous year for state fiscal years (SFY) 2023, 2024, and 2025.
Summary: Allows the Division of Medicaid (DOM) to reimburse for chiropractic se1vices at seventy percent (70%) of the Medicare rate in effect as of Januaiy 1, 2022 and as may be adjusted each July thereafter.
Summary: Allows the Division of Medicaid (DOM) to reimburse for psychiatric therapeutic procedures that are billed using Current Procedural Terminology (CPT) codes at ninety percent (90%) of the Medicare fee schedule in effect on January 1, 2022 and as may be adjusted each July thereafter.
Summary: Allows family planning services to be reimbursed ninety percent (90%) of the Medicare fee schedule in effect January 1, 2022 and as may be adjusted each July thereafter.
Summary: Allows the Division of Medicaid (DOM) to reimburse for therapy services at ninety percent (90%) of the Medicare rate in effect on January 1, 2022. and as may be adjusted each July thereafter.
Summary: State Plan Amendment (SPA) 22-0010 allows reimbursement rates for orthotics and prosthetics to be updated annually based on eighty percent (80%) of the Medicare rate.
Summary: This SPA proposes to allow for certain medications to be filled in 90-day supplies. This is a change the state made during the COVID-19 Public Health Emergency (PHE) period, and this SPA seeks to extend the provision beyond the PHE timeframe.
