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 Tab​le of Contents​​​​​​
  
• Section 1 – Single State Agency Organization
  
• Section 2 – Att. 2​.2A – Mandatory and Optional Coverage Groups (MAGI and non-MAGI)​​​​​​
• Att. 2.6A – Financial Eligibility Rules for Coverage Groups (MAGI and non-MAGI)​
  
• Section 3 – A​tt. 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: In​patient, 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​
  
• MACPro SPAs​ ​​- Eligibility Groups and Health Homes
  

Emergency Authority and Maryland COVID-19 Disaster State Plans

The COVID-19 Disaster State Plans expire no later than 60 days after the end of the public health emergency.

• MD-20-0001
  
• MD-20-0003
  

Maryland Children’s Health Insurance Program (CHIP)

• Maryla​nd CHIP​ State Plan​ ​​