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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to implement an incremental increase to the current Urban Indian Organization (UIO) Prospective Payment System (PPS) rates effective July 1, 2021, through the duration of the Public Health Emergency (PHE).
Summary: This SPA authorizes coverage and reimbursement of COVID-19 vaccine and vaccine administration, in compliance with the American Rescue Plan (ARP) Act of 2021.
Summary: This SPA authorizes coverage and reimbursement of COVID-19 treatment, including treatment of a condition that could complicate treatment of COVID-19, in compliance with the American Rescue Plan (ARP) Act of 2021.
Summary: This plan amendment updates the date of the fee schedule for state plan services on the Introduction Page. This will allow the department to update Medicaid fees, additions, deletions, or changes to procedure codes when Medicare releases and updates their fee schedule.
Summary: This amendment addresses third party liability and related Medicaid payments associated with prenatal care, preventive pediatric services, and medical child support.
Summary: This amendment establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
Summary: This amendment removes coverage of the Nurse Advice Line from the state plan as the result of increased access to primary care advice through telehealth.
