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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: Implements the Comprehensive Maternal Care (CMC) program, which is a comprehensive care coordination and service model incorporating supportive care for expectant and postpartum individuals.
Summary: This SPA updated the fee schedule effective dates for several Medicaid programs and services. This is a regular, budget neutral update to keep rates and billing codes in alignment with the coding and coverage changes from the Centers for Medicare and Medicaid Services (CMS), the state, and other sources.
Summary: This SPA modifies the per member per month rate for medical home payments, specifically for primary care providers with assigned Tailored Care Management eligible beneficiaries.
Summary: Updates Delaware State Plan regarding telemedicine, specifically, to sunset telemedicine Attachment 3.1-A introductory pages 1-2 and to modify language in Attachment 4.19-B Page 24.
Summary: This SPA provides Colorado with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This amendment makes permanent the addition of Intensive Outpatient Therapy, previously approved under disaster relief authority, remove a prior authorization requirement, and removes some face-to-face service delivery requirements.
Summary: The SPA uses American Rescue Plan Act (ARPA) reinvestment funds to establish peer recovery support services in SUD setting in alignment with behavioral health priorities and stakeholder response. This SPA also removed the waiver requirement for prescribing buprenorphine for opioid use disorder based on the federal Drug Enforcement Agency (DEA) Announcement.