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Medicaid State Plan Amendments

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.

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Showing 1 to 10 of 31 results
Transmittal Number: MD-24-0019
State: Maryland
Summary: This plan amendment updates the reimbursement of prosthesis to include for purposes of whole-body health for participants in Fee-for-Service.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-24-0014
State: Maryland
Summary: Health Homes Payment Methodologies Under this SPA, for dates of service beginning July 1, 2024, the Maryland Medical Assistance Behavioral Health, Health Home program reimbursement rates will increase by 3%.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-24-0013
State: Maryland
Summary: This SPA allows Maryland to cover select imported drugs due to shortages identified by the Food and Drug Administration, as well as to provide the reimbursement methodology for select prescribed drugs.
Approval Date:
Effective Date:
Topics:
  • Drug Shortages
  • Prescribed Drugs
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-24-0010
State: Maryland
Summary: This plan amendment updates Interim Fee-for-Service.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-24-0011
State: Maryland
Summary: This plan amendment updates the Reimbursement Rates for the 1915 Home and Community Based Services Program.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-24-0007
State: Maryland
Summary: This amendment proposes to allow Medicaid-enrolled pharmacists to bill Maryland Medicaid for professional services rendered within their lawful scope of practice.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
  • Drugs and Related Services
  • Preventative Services
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-24-0002
State: Maryland
Summary: This amendment implements an 8% rate increase for Nursing Facilities Program.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MD-24-0003
State: Maryland
Summary: This plan amendment implements a rate increase for the Targeted Case Management (TCM).
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MD-24-0001
State: Maryland
Summary: This state plan amendment clarifies coverage of crisis intervention services and service rates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
  • Benefits
Links:
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Transmittal Number: MD-24-0009
State: Maryland
Summary: This SPA establishes an emergency interim payment methodology for inpatient and outpatient hospitals, nursing facilities, and hospice services affected by the Change Healthcare cybersecurity incident.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT