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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 allows the Division of Medicaid to include coverage of home health services provided by a licensed practical nurse under the supervision of a registered nurse.
Summary: This SPA allows coverage of authorized drug imports when there is inadequate supply of the fully FDA-approved, non-imported drug product during a recognized critical drug shortage.
Summary: This SPA allows coverage of medically necessary prescribed drugs that are not covered outpatient drugs, including drugs authorized for import by the U.S. Food and Drug Administration (FDA) during drug shortages.
Summary: This SPA proposes to amend the State Plan to create a new, temporary non-preferred status, and establish criteria for new-to-market drugs that have not yet been reviewed by the Drug Utilization Review Board.
Summary: This SPA proposes to amend the State Plan to cover prescribed drugs when medically necessary during drug shortages identified by the United States Food and Drug Administration (FDA).
Summary: This amendment is to extend the time frame for Targeted Case Management (TCM) for pregnant individuals receiving services after the end of their pregnancy to 12 months to align with the state’s extended eligibility coverage of 12 months post-partum for Medicaid-eligible pregnant individuals.
Summary: This amendment proposes to allow licensed professional counselors, licensed marriage and family therapists, and certified peer specialists to deliver services and be reimbursed by Federally Qualified Health Centers according to the Practitioner's Practice Act.
Summary: This SPA is to amend the provisions governing children’s and adult mental health services to expand the mental health professionals eligible to provide therapeutic services to include provisionally licensed professional counselors, provisionally licensed marriage and family therapists, and licensed master social workers.
Summary: This amendment proposes to update the description of physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders to align with 42 CFR 440.110. It will also add coverage for medically necessary audiological services for members with full benefits who are ages 21 years and older.
