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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 purpose of this SPA is to limit the number of managed care plans in the Healthy Connections managed care program to no less than two and no more than four based on analyses of projected enrollees.
Summary: The purpose of this SPA is to remove health homes language from Attachment 3.1F, due to the termination of the Health Homes Asthma and the Health Homes SMI programs.
Summary: This amendment for Tailored Care Management is to increase the Health Home payment rate for higher acuity beneficiaries and to provide assurances of mandatory Core Set measures.
Summary: The purpose of this SPA is to cover two optional eligibility groups under managed care: children under age 19 with income between 196% and 318% who have third-party liability and the work incentive group, pursuant to section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act, which is limited to individuals aged 65 years and older.
Summary: This amendment is to update state plan 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 outlined in 42 CFR 431.16 and 437.10 through 437.15. This SPA also includes state attestation that it will submit mandatory Health Home Core Set data pursuant to 42 CFR §§ 437.1O and 437.15.
Summary: The purpose of this SPA is to move services provided in Developmental Evaluation Centers (DECs) and organ transplant services from FFS to managed care.
Summary: Move authority for the Tribal Health Improvement Program (T-HIP) from a 1915(b) waiver to a 1932(a) SPA, while further aligning the program design with primary care case management entity requirements found in 42 CFR § 438.2.
