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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: Proposes to authorize the state to enter outcome-based supplemental rebate agreements with drug manufacturers for drugs provided to the Medicaid program
Summary: In this time-limited state plan to respond to the COVID-19 national emergency, AZ has elected to temporarily: Expand eligibility to cover COVID-19 testing for uninsured individuals; Streamline enrollment for children whose family income changes during the disaster period; Suspend all cost sharing and premiums; and Expand access to covered outpatient drugs through adjustments to prior authorization and exceptions to the preferred drug list in the event of a drug shortage.
Summary: Proposes to allow the state to comply with the Medicaid Drug Utilization review (DUR) provisions included in 1004 of the SUPPORT for Patients and Communities Act with the effective date of October 1, 2019.
Summary: Includes new drug review and utilization requirements set forth in section 1902(oo) of the Act. Specifically, Maryland is updating language to identify claim review limitations on safety edits and retrospective reviews, programs to monitor antipsychotic medications to children and fraud and abuse identification requirements
Summary: This SPA proposes to bring Maryland intocompliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Summary: Add the ability for OHCQ Licensed or Certified Substance Use Disorder Program who employ a data 2000 Waiver Physician, to reimbursed for buprenorphine and other medication assisted treatment, as appropriate.
