Maryland Medicaid State Plan

What is a state plan?

A Medicaid and Children’s Health Insurance Program (CHIP) state plan is an agreement between a state and the Federal government telling 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 shows groups covered, services provided, methods for provider reimbursement and the administrative activities in use in the state.

State Plan Format and Files

The state plan has seven main sections with larger sections subdivided for ease of use, in addition to the MACPro SPAs.

Overall Table of Contents

Section 1 – Single State Agency Organization

Section 2 – Att.2.2A – MAGI Coverage and Eligibility
Att. 2.6A – Non-MAGI Coverage and Eligibility

Section 3 – Att. 3.1A – Services and General Provisions

Att. 3.1B – Att. 3.2A – Medically Needy Services, 1915(i) State Plan Services, Community First Choice

Section 4 – General Program Administration

Att. 4.14A – Att. 4.19B – Payment for Services: Inpatient, Outpatient, HCBS, NEMT

Att. 4.19C – Att. 4.44 – Skilled Nursing Facility Payment, Timely Claims, Data Exchanges, Enforcement

Sections 5, 6 and 7 – Personnel Admin, Financial Admin, General Provisions

All Approved MACPro SPAs