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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 permit flexibility regarding preparation of eligibility applications in - person by caseworkers employed by the State of Maryland and navigators.
Summary: Description: This SPA expands coverage to Children born to persons eligible for CHIP or the 1115 BadgerCare Reform waiver at the tome of birth.
Summary: Proposes to establish and authorize payment for Nutrition Services provided to children/youth by providers licensed under Article 29-I. Nutrition services are already reimbursed by providers under Article 25 and 28. This clarifies coverage under EPSDT in a statewide, comparable manner.
Summary: This amendment revises Rehabilitation services coverage and payment to enhance the continuum of care. The state has added a new service to the mental health and substance use disorder treatment continuum of care, identified the component services that are available under larger "umbrella" services, and updated practitioner/provider qualifications.
Summary: This amendment is to comply with federal requirements on premium and cost sharing tracking and assessing copays on non-emergency use of services provided in emergency departments. This amendment proposes to eliminate copayments in the Medi-Cal program effective July 1, 2022.
Summary: This plan amendment carves select outpatient hospital opioid antagonist drugs, which are otherwise compensated through the Enhanced Ambulatory Patient Groups (EAPG) payment methodology, out of the EAPG methodology and reimburses them at the lower of billed charges or the fee schedule rate.
Summary: Medicaid State plan submitted under transmittal number 22-0022 to increase inpatient per diem rates for Children's Specialty hospitals and to continue psychiatric add-ons for certain freestanding psychiatric hospitals.