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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 changes to state plan coverage of other licensed practitioner services to include licensed mental health therapists, licensed social service workers, licensed substance use disorder counselors, and licensed behavioral health coaches.
Summary: The SPA updates and clarifies provisions including provider qualifications for psychiatric diagnostic evaluation, mental health assessment, psychological testing, psychotherapy, pharmacologic management, nurse medication management, therapeutic behavioral services, psychosocial rehabilitative services, and peer support services.
Summary: The SPA provides assurances that the State complies with federal requirements regarding coverage of routine patient care associated with participation in clinical trials as required by the Consolidated Appropriations Act, 2021.
Summary: This SPA added pharmacists under other licensed practitioners since the state's scope of practice was expanded to allow pharmacist to prescribe certain drugs of devices with their scope of training and experience.
