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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 was to comply with the Consolidated Appropriations Act for 2021, which amended the Medicaid statute to add as a mandatory benefit, in both state plan and benchmark and benchmark equivalent coverage, for “routine patient costs for items and services furnished in connection with a qualifying clinical trial.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to provide a 5% increase in payment rates for certain services provided by the Office of Developmental Disability Services.
Summary: This amendment proposes temporarily income disregard to allow Puerto Rico Medicaid Program to temperately increase the effective monthly income standard for the Optional Categorically Needy ABD Group and all Medically Needy Groups.
Summary: Allows supplemental payments to nursing facilities, home and community-based residential facilities and in-home agencies that participate to support provision of health care premiums for eligible employees as required by SB 800 passed during the 2021 Legislative session.
Summary: This amendment proposes to add services to the Newborn Nurse Home visiting program, including maternal and newborn physical assessment; anticipatory and supportive guidance.
Summary: To update policies regarding how Medicaid applications may be submitted, the frequency and methods used for renewal of eligibility, requirements when determining ineligible assistance with application and renewal notice requirements and the use of authorized representatives.
