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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 adds Orthodontic services to the Early Periodic Screening, Diagnostics and Treatment (ESPDT) benefit for patients under age 21.
Summary: This Amendment will update its cost-effectiveness calculation for the eligibility group described in section 1902(e)(3) of the Social Security Act (the Katie Beckett eligibility group).
Summary: This amendment adds on and off-island outpatient dialysis services to within dialysis clinics and Free standing ESRD clinics. Additionally, this amendment makes technical edits to dental services in the state plan.
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: Adding a new 1915 home and community-based services (HCBS) benefit, transmittal number NE-24-0005, titled Therapeutic Family Care Crisis Support Services program. CMS conducted the review of the state’s submittal according to statutory requirements in Title XIX of the Social Security Act and relevant federal regulations.
Summary: This plan amendment will begin the coverage of interpretation services that are provided in conjunction with another Medicaid covered service.
Summary: This plan amendment increases payment rates for dental services, pharmacy dispensing fees, lactation counseling services, and personal assistance services (PAS).
