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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 plan continues a temporary extension of an Alternative Payment Methodology (APM) for Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC). This APM will continue to provide coverage without copay or cost-sharing, for the administration of COVID-19 vaccines by staff who have the authority under state law to administer the vaccine, in the FQHC and RHC settings during a COVID-19 vaccine-only visit through September 30, 2024.
Summary: This plan amendment authorizes the Department to increase the funding for supplemental payments to qualifying acute care general hospitals that treat a high volume of opioid use disorder patients in their emergency room.
Summary: This plan amendment is in response to the State Health Official (SHO) Letter #23-001 “Coverage and Payment of Interprofessional Consultation in Medicaid and the Children’s Health Insurance Program” issued January 5, 2023. In accordance with the SHO, the Department is updating its State Plan to reflect the date that interprofessional consultation services were added to the MA Program Fee Schedule.
Summary: This plan amendment updates the Alternative payment methodology to increase funding for FQHCs located in/operated by cities of the first class.
Summary: This plan amendment authorizes the Department to make an additional supplemental payment to certain nonpublic nursing facilities in a county of the eighth class.
Summary: This plan amendment authorizes the Department to make an additional payment to nonpublic and county nursing facilities that qualified for supplemental ventilator care and tracheostomy care payments.
