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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: The state proposes changes to improve access to primary behavioral health services by allowing licensed clinical social workers, licensed professional counselors, and licensed marriage and family therapists to enroll as Medicaid fee-for-service providers and deliver behavioral health services permitted within the scope of their practice.
Summary: Changes to the early and periodic screening, diagnostic and treatment benefits, and related payment methodologies. The proposed changes will more accurately align payments for direct medical services, which are outlined in an individualized education plan and supplied in a school-based setting, to actual costs for providing these services in a school setting.
Summary: This SPA proposes to amend the language provisions for coverage of selective non-legend outpatient drugs. This SPA also updates additional Pharmacy coverage items on the State Plan pages.
Summary: This SPA proposes to amend the pharmacy page's provision to cover all prescriptions for FDA-approved oral contraceptives for up to a 12-month supply at one time.
Summary: The state proposes to include an assurance that the state covers routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials.
Summary: Effective October 1, 2018, this amendment adds coverage of long term residential substance use disorder services, which would allow an individual to initiate and receive services to treat substance use disorders in a less intense care setting, to the state's alternative benefit plan (ABP).
