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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 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 SPA establishes guidelines for the medical allocation for unallocated settlements, judgments, and/or awards to avoid unnecessary costs associated with litigation over the medical allocation of an unallocated settlement, judgment, and/or award.
Summary: This Amendment updates 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 plan amendment authorizes supplemental add-on payments to the fee schedule rates for eligible ground emergency transports provided between July 1, 2024, and June 30, 2025.
Summary: This plan amendment authorizes supplemental add-on payments to the fee schedule rates for eligible ground emergency transports provided between January 1, 2024, and December 31, 2024.
Summary: This amendment adds coverage for behavioral health provided by credentialed School Psychologists, School Social Workers, and School Counselors in school-linked settings under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit and adds those providers as eligible for the Targeted Rate Increase fee schedule.
Summary: This SPA expands the continuum of community-based services and evidence-based practices available through Medi-Cal specialty behavioral health delivery systems by adding coverage for assertive community treatment (ACT), clubhouse services, and coordinated specialty care for first episode psychosis (CSC) and making other clarifications under the rehabilitative mental health services benefit.
Summary: This SPA amendment, the state is implementing the final round of rate increases from a 2019 rate study, adding a new service called Person-Centered Future Planning, increasing the rate for Financial Management Services, and adding a new provider type to Community Living Arrangement Services.
