An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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 updates the licensed practitioner benefit to allow school-based providers with Department of Education endorsement and a current licensure to include school counselors, school social workers, and school psychologists to provide services to school-aged Medicaid recipients.
Summary: This amendment extends coverage to members residing in a broader geographic area that qualify for Target Case Management (TCM) benefits for Integrated Care for Kids (InCK) in New Haven, Connecticut.
Summary: This amendment is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Home Health Core Set(s) of measures.
Summary: This amendment looks to enable recoveries of overpayments in the Medicaid State Plan. The Medicaid recovery audit contractors seek to increase the maximum allowable Medicaid contingency fee from 12.5 percent to 17.46 percent for all claim types.
Summary: This amendment is to reduce the income standard for the parents and caretaker relatives eligibility group from 155 percent of the federal poverty level to 133 percent of the federal poverty level.
Summary: This SPA establishes payment at the All-Inclusive Rate (AIR) for pharmacy service encounters, in addition to the 5-encounter limit for clinic services, at Indian Health Service (IHS) and Tribal 638 pharmacies.
Summary: This State Plan Amendment will increase the amount for the personal needs allowance to eligible recipients in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). This amendment will also allow for COLA increases annually.
Summary: This amendment will add back into the plan the language for Community Health Workers (CHWs) erroneously left off the NV-23-0016 SPA approval, which adds CHWs as providers under the preventive services benefit.
