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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 is to allow for home-based Behavior Rehabilitation Services to be paid based on a state-wide fee schedule per service; update minimum requirement for staff to address staffing shortages; and update terminology to avoid confusion between mental health and substance use disorder rehabilitation services.
Summary: The purpose of this SPA is to amend the provisions governing outpatient hospitals in order to update reimbursement to out-of-state hospitals for consistency with in-state rates.
Summary: State Plan Amendment (SPA) 22-0010 allows reimbursement rates for orthotics and prosthetics to be updated annually based on eighty percent (80%) of the Medicare rate.