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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 proposes to add the requirement for Tier 2 and Tier 3 PCPlus practices to ensure the provision of community based Community Health Worker (CHW) services. It also includes minor methodological and operational updates.
Summary: This amendment proposes contracting with a Recovery Audit Contractor to identify underpayments and overpayments of Medicaid claims under the State Plan and any waiver of the State Plan.
Summary: Adds Licensed Behavior Analysts (LBAs) to the definition of a "Credentialed Addiction Treatment Professional." It recognizes them as a provider type under the Addiction and Recove1y Treatment Services (ARTS) program.
Summary: This amendment proposes to allow the Division of Medicaid to request an exemption from the federal requirement to contract with a Recovery Audit Contractor.
Summary: This amendment proposes to expand the scope of covered dental services that are available to individuals over age 21. Individuals over age 21 will receive the following medically necessary dental services: diagnostic, preventive, restorative, periodontal, prosthodontic, orthodontic, endodontic, emergency dental services, and oral surgery (inpatient and outpatient).
