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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 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 update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This amendment continues certain flexibilities previously approved in Disaster Relief State Plan Amendments and a Section 1135 Disaster Relief waiver.
Summary: This amendment proposed to memorialize the new income standards for its optional state supplement program and increase its medically needy income level.
Summary: This amendment is to provide a mandatory 12 months of continuous eligibility (CE) for children under 19 in Medicaid and CHIP, as required by Section 5112 of the Consolidated Appropriations Act of 2023.
Summary: This SPA is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that
Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
