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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 discontinue the Recovery Audit Contractor (RAC) program. These changes are being made due to the State having a high managed care population at 83% compared to 17% Fee for Services; therefore, the state does not project any large recoveries in the future for the RAC program.
Summary: proposes to update the language pertaining to the admission review for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).
Summary: Effective July 1, 2020, this amendment increases the number of FTEs for the states Graduate Medical Education (GME) program which will provide access to care in more rural areas of the state. Both public and private hospitals will be allowed to participate.
Summary: Effective January 01, 2021, this amendment adds substance use disorder (SUD) as an additional eligibility criterion for Health Home Services. For payments made to Health Homes providers for Health Homes participants who newly qualify based on the Health Homes program’s additional condition coverage under this amendment, a medical assistance percentage (FMAP) rate of 90% applies to such payments for 8 quarters from the effective date of this SPA. The FMAP rate for payments made to health homes providers will return to the state's published FMAP rate at the end of the enhanced match period.
Summary: Effective January 01, 2021, this amendment eliminates the resource standards for the following Medicare Savings Plan categories: Qualified Medicare Beneficiaries, Specified Low-income Medicare Beneficiaries; and Qualified Individuals.
