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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 amendment updates fee schedules language for service rehabilitation benefits section to comply with federal requirements and updates outdated language.
Summary: This plan amendment modifies the reimbursement for the Primary Care Case Management Program and aligns it with the Healthy Connections Value Care Program.
Summary: Amendment to the State Plan to update the Private, State, and County-Owned Nursing Facility Supplemental Payment section to reflect changes requested by CMS before implementing the Department’s new Patient Driven Payment Methodology Upper Payment Limit (PDPM UPL) methodology.
Summary: Amendment to the State Plan to implement a new price-based methodology for private nursing facilities and cost-based methodology for state-owned nursing facilities.
Summary: The purpose of this SPA is to comply with the requirements within section 1905(a)(4)(F) of the Social Security Act to cover COVID-19 vaccines, vaccine administration, testing and treatment.
Summary: This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Summary: Effective for services on or July 1,2021, this amendment updates the supplemental payment methodology to hospitals for inpatient and outpatient services. Specifically, these changes will associate supplemental payments with quality of services and participation in the Healthy Connections Value Care (HCVC) program, further linking inpatient and outpatient hospital services to quality and value of patient care.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to modify payments to providers in line with the state’s American Rescue Plan Home and Community Based Services (HCBS) Spending Plan.
