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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 updates the fee schedule for services provided by the Child and Adolescent Mental Health Division (CAMHD) and to modify the rehabilitative services language for peer support services.
Summary: This SPA updates the payment methodology for prescribed drugs and allows for coverage of drugs authorized for import by the Food and Drug Administration to mitigate the effects of a drug shortage.
Summary: This amendment is to add Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) to the list of professions that are accepted as Medicaid providers for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) as required by the Consolidated Appropriations Act 2023.
Summary: This SPA authorizes increased federal financial participation (FFP) for newly-eligible individuals receiving postpartum coverage and further includes the addition of Attachment D, which describes the special circumstances and other proxy adjustments that are applied to account for the proportion of individuals covered under the extended postpartum coverage option who would otherwise be eligible for coverage in the adult group and for the newly eligible FFP under section 1905(y) of the Social Security Act;
Summary: The SPA increases the nonemergency services’ limit to $2,000 per fiscal year to align with the administrative rule change and clarifies the prior authorizations requirements to align with current practice.
