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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: Annual assurance of the pharmacy program's adherence to the FULs requirement of federal regulation regarding expenditures for multiple source drugs.
Summary: This SPA provides annual assurance of the pharmacy program adherence to the FULs requirements of federal regulation for the time period October 1, 2021 through September 30, 2022.
Summary: Annual assurances of the pharmacy program adherence to the requirement of federal regulations regarding expenditures for multiple source drugs.
Summary: Updates prescribing providers for preventive services from only physicians to license practitioners within the scope of their license which is in line with industry standards and federal language.
Summary: Brings state into compliance with third party liability requirements to apply cost avoidance procedures to claims for prenatal services, to make payments to pediatric preventive services without regard to third party liability, and to make payment without regard to third party liability for up to 100 days for claims for child support enforcement to beneficiaries.
Summary: include new Federal requirements that transpo1iation providers and drivers must meet in order to provide Non-emergency Medical Transpo1iation (NEMT) services under the Medicaid program.
Summary: Updates the Primary Care Physician Consultant to the Specialized Healthcare Consultant, allowing Health Homes flexibility in offering additional consultation from a variety of healthcare professions for special populations. Also updates the Per Member Per Month (PMPM) payment for Community Mental Health Centers (CMCH) Health Homes.
