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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 SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to modify the definition of home-based habilitation to include health and safety supports and services required to maintain a member’s involvement in online education or e-learning, specifically for members ages 17-21 residing outside of the family home. In addition, the SPA seeks approval for retainer payments made in April 2020 to providers of 1915(i) state plan home and community based (HCBS) habilitation services including day habilitation, prevocational services, and supported employment.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, allow for flexibility in hospital presumptive eligibility, suspend cost sharing and premiums for all services for all beneficiaries, add new services under 1915(i), and allow for other flexibilities in the 1915(i) program.
Summary: This amendment updates provisions pertaining tointermediate care facility for individuals with intellectual disabilities (ICF-IID) services, including for Medicaid's share of assessment fees.
Summary: This SPA allows individuals, with income between 101-133% of FPL, who use to be mandated into the MarketPlace plan to elect enrolling in the Health and Wellness Plan.
