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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 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.
Summary: This SPA elects the Individuals Eligible for Family Planning Services (“Family Planning”) eligibility group and elect to add Presumptive Eligibility (PE) for the Family Planning eligibility group.
Summary: The state adopts 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: Allows Hospitals Separate Reimbursement for Long Acting Reversible Contraceptive (LARC) Devices Provided in the Inpatient Hospital Setting Immediate Postpartum.
Summary: Provides for a Per Diem Rate Reimbursement for Long-Term Care Facilities Serving Persons Less than 22 Years of Age with Clinically Complex Residents.
