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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 accept Medicaid eligibility decisions made by the Exchange or other agencies administering insurance affordability programs and to furnish Medicaid in to the same extent and in the same manner as if the applicant had been determined by the state to be eligible for Medicaid.
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 SPA adds language to the State Plan page attesting that the state is in compliance with the Federal Upper Limit (FUL) requirements for multiple source drugs.
Summary: This amendment updates the Medicare fee schedules, MO HealthNet fee schedules, and the National Dental Advisory Service (NDAS) used to determine outpatient reimbursement rates.
Summary: This amendment adds coverage of doula services to enhance the bi1ihing experience, reduce complications, and improve outcomes for women and infants.
Summary: This plan amendment increases certain rates for physician, dental, podiatry, x-ray, lab, family planning, EPSDT, emergency ambulance, and home health services.
