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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 allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily implement a disregard of income that would have otherwise been part of an individual’s liability for institutional or home and community-based waiver services based on application of the post-eligibility treatment-of income (PETI) rules, but which became countable resources on or after March 18, 2020.
Summary: Long acting reversible contraceptive (LARC) devices are no longer included in the Diagnosis Related Group (DRG) rates. LARC devices will be reimbursed on a fee-for-service basis.
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 waive requirements for signatures for dispensing of drugs during PHE.
Summary: This amendment allow licensed mental health practitioner visits in nursing facilities. This SPA, which adds coverage and reimbursement of the Parent Peer Support Services
Summary: This plan amendment reflects the repair rates for maintenance of DMEPOS (durable medical equipment, prosthetics, orthotics and supplies) equipment which will be increased to 65% of the Medicare fee schedule.
Summary: Effective for services on or July 1,2021, this amendment updates the supplemental payment methodology to hospitals for inpatient and outpatient services. Specifically, these changes will associate supplemental payments with quality of services and participation in the Healthy Connections Value Care (HCVC) program, further linking inpatient and outpatient hospital services to quality and value of patient care.
Summary: Physician Administered Drugs (PADS) submitted under the medical benefit, including those drugs purchased through the 340B program, will be reimbursed at Medicare Part B fee schedule rates.
