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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 SPA increases access to dental services for children by allowing Ambulatory Surgical Centers to perform certain dental procedures, as well as, updates the reimbursement language to the corresponding 4.19B pages to reflect fees equal to 80 percent of the current Medicare approved ASC facility fee.
Summary: This SPA adds information for preventative dental services for children age 20 and under that was inadvertently removed from the Medicaid state plan.
Summary: This SPA amends Dental Services, Denturists and Denture Services, and Dental Hygienists Services, removing the " by report" payment methodology and describe the new method for setting fees, distribute a 2% provider rate increase and update ceramic crown coverage to posterior teeth for EPSDT services as per current dental practice standards.
