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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 expands the Targeted Case Management Family Connects® Nurse Home Visiting program into Douglas County and revise the provider qualifications for the program.
Summary: To implement Express Lane Eligibility (ELE) to streamline and expedite renewal of eligible individuals in the Maryland Medicaid Assistance Program and Maryland Children’s Health Program (MCHP).
Summary: To expand coverage for school-based psychological services when provided to students who do not have an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP).
Summary: This SPA allows coverage of authorized drug imports when there is inadequate supply of the fully FDA-approved, non-imported drug product during a recognized critical drug shortage.
Summary: This amendment proposes to allow Medicaid-enrolled pharmacists to bill Maryland Medicaid for professional services rendered within their lawful scope of practice.
Summary: This amendment authorizes additional provider types the Oregon state plan to include Licensed School Psychologist, Licensed School Social Worker and Licensed School Counselor as Medicaid allowable providers for services provided in the school setting.
Summary: To include coverage for peer recovery support services within the state’s Other Diagnostic, Screening, Preventive and Rehabilitative Services benefit and the Mandatory Medication-Assisted Treatment (MAT) benefit. Individual peer support services will be reimbursed at a rate of $16.38 per 15-minute unit, and group peer support services will be reimbursed at a rate of $4.55 per 15-minute unit. This SPA also removes the DATA 2000 waiver requirement for the prescribing of buprenorphone for opioid use disorder.
Summary: To reimburse for community violence prevention services. Coverage will be extending to this service at a fee-for-service rate of $32.76 per 30-minute increments up to a maximum of 100 increments in a rolling 12-month period.
