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Medicaid State Plan Amendments

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.

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Showing 1 to 10 of 15662 results
Transmittal Number: KS-25-0003
State: Kansas
Summary: This plan amendment will reimburse pharmacists for Medication Therapy Management (MTM) intervention services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ND-25-0008
State: North Dakota
Summary: Clarifies language for existing benefits, specifically as they relate to those under the age of 21. The amendment will align the Alternative Benefits Plan (ABP) with the changes to traditional Medicaid.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
  • Coverage
Links:
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Transmittal Number: NH-25-0012
State: New Hampshire
Summary: This amendment is to increase its medically needy income level (MNIL).
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
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Transmittal Number: WI-25-0006
State: Wisconsin
Summary: This amendment modified the maximum amount allowed for the maintenance of a home of institutionalized beneficiaries to reflect the Social Security Cost-of-Living Adjustment (COLA).
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: WI-25-0006-A
State: Wisconsin
Summary: The state memorialized the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under Wisconsin's State Plan.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: PA-25-0006
State: Pennsylvania
Summary: This plan amendment establishes a new class of supplemental payments to qualifying Medical Assistance (MA) enrolled acute care general hospitals that serve a disproportionate share of elderly individuals and relies on primarily government payers.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: TX-25-0014
State: Texas
Summary: This plan amendment updates the Clinical Diagnostic Laboratory Services fee schedules (CDL), and removes language related to COVID-19 lab rates that is no longer relevant.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: OR-25-0004
State: Oregon
Summary: This plan amendment increased the rate for children’s foster care under the 1915(k) state plan option.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-25-0007
State: Washington
Summary: This plan amendment updated the fee schedule effective dates for several Medicaid programs and services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: PA-25-0005
State: Pennsylvania
Summary: This plan amendment establishes a new class of disproportionate share hospital (DSH) payments to qualifying Medical Assistance (MA) enrolled acute care general hospitals to promote access to comprehensive inpatient services for MA eligible persons.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT