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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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Transmittal Number: NE-21-0007
State: Nebraska
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment for nursing facilities to receive an additional $20 per day payment per Medicaid beneficiary effective from the dates of January 1, 2021 to June 30, 2021.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
Links:
Transmittal Number: NE-21-0004
State: Nebraska
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow pharmacists to order and administer certain Covid-19 vaccines, including Pfizer and Moderna vaccines currently available, where a pharmacist has met CMS training requirements and state regulations for training and vaccine administration.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Vaccine
Links:
Transmittal Number: CT-21-0006
State: Connecticut
Summary: Incorporates the 2021 Healthcare Common Procedural Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Radiology and Independent laboratory fee schedules 
Approval Date:
Effective Date:
Topics:
  • adjustment codes
Links:
Transmittal Number: NY-20-0023
State: New York
Summary: Continues UPL supplemental payments to private hospitals for inpatient services in the amount of $193,635,130 for state fiscal year 2021
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: CO-20-0028
State: Colorado
Summary: This plan amendment allows rebalancing the behavioral health fee for service and Residential Child Care Facility (RCCF) rates
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: MD-21-0003
State: Maryland
Summary: This amendment provides a three and one-half percent increase for 1915(i) home and community-based services
Approval Date:
Effective Date:
Topics:
  • Health Homes
  • Financing & Reimbursement
Links:
Transmittal Number: NV-21-0002
State: Nevada
Summary: Amends its 1915(i) state plan home and community-based services (HCBS) benefit
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
Transmittal Number: MO-20-0019
State: Missouri
Summary: This plan amendment increases the fee schedule rate for Ground Ambulance services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: MO-20-0019
State: Missouri
Summary: Effective October 1, 2020, this amendment increases the fee schedule rate for Ground Ambulance services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: VA-21-0011
State: Virginia
Summary: Effective March 1, 2021, this amendment solicits advice from Tributes and Indian Health Programs, prior to submitting any plan amendments, waiver requests, and proposals for demonstration projects that are likely to have a direct effect on Indians, Indian Health Programs, or Urban Indian Organizations. 
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Tribal Issues
Links:
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