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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 coverage for the human papillomavirus (HPV) vaccine for persons 46 years of age or older who meet certain medical criteria.
Summary: This SPA implements coverage of the Advisory Committee on Immunization Practices' recommended vaccines for adult Medicaid beneficiaries without cost sharing, in compliance with Section 11405 of the Inflation Reduction Act of 2022.
Summary: This SPA updates the professional qualifications for technicians delivering Adaptive Behavior Support services to Medicaid beneficiaries diagnosed with autism spectrum disorder.
Summary: This SPA proposes to update the language on the state’s excluded drug list, including provisions for coverage of select over-the-counter (OTC) drugs.
Summary: This SPA is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This amendment proposes to provide services to identified recipients under age 21 to improve family functioning by clinically stabilizing the living arrangement, promoting reunification, or preventing the utilization of out-of-home therapeutic venues (i.e., psychiatric hospitals, psychiatric residential treatment facilities, or residential treatment services).