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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.

Search the Text of Medicaid State Plan Amendments
Showing 1 to 10 of 26531 results
Transmittal Number: CO-23-0013
State: Colorado
Summary: This plan amendment intends to make the 90% reimbursement of net invoice for outpatient hospital physician-administered drugs permanent.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
Transmittal Number: VA-23-0003
State: Virginia
Summary: To adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
Transmittal Number: NY-23-0034-MA
State: New York
Summary: To include coverage and reimbursement for gambling treatment provided to individuals receiving services from the Office of Addiction Services and Supports (OASAS) certified services, pursuant to 14 NYCRR Part 818 Chemical Dependence Inpatient Services, 14 NYCRR Part 820 Residential Addiction Rehabilitation Services, 14 NYCRR Part 822 Outpatient Addiction Rehabilitation Services, 14 NYCRR Part 825 Integrated Outpatient Addiction Rehabilitation Services and 14 NYCRR Part 857, with the OASAS gambling designation, when services are for gambling disorder/problem gambling only.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
Transmittal Number: PA-23-0011
State: Pennsylvania
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency.  The purpose of this amendment is to temporarily extend the Alternative Payment Methodology (APM) to pay Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) for COVID-19 vaccine administration.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
Transmittal Number: MA-23-0003
State: Massachusetts
Summary: This SPA proposes to update the coverage language for certain nonprescription drugs on the state’s Pharmacy coverage pages.
Approval Date:
Effective Date:
Topics:
  • Prescribed Drugs
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Transmittal Number: TX-22-0023
State: Texas
Summary: This amendment is to expand the settings an ambulance provider may transport a beneficiary to from only a nursing facility or hospital to any appropriate setting.
Approval Date:
Effective Date:
Topics:
  • Transportation
Links:
Transmittal Number: GU-23-0002
State: Guam
Summary: This SPA implements coverage of the new mandatory benefits of COVID 19 Vaccines and Administration of the Vaccines, Diagnostic and Screening Tests, and Treatment, Specialized Equipment and Therapies, and Preventive Therapies in accordance with the requirements of Section 9811 of the American Rescue Plan (ARP) Act.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Reimbursement
Links:
Transmittal Number: MA-23-0026
State: Massachusetts
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 disregard income that would have otherwise been counted for purposes of determining eligibility.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Eligibility
Links:
Transmittal Number: MA-22-0025
State: Massachusetts
Summary: This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Reimbursement
Links:
Transmittal Number: WY-22-0005
State: Wyoming
Summary: This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Reimbursement
Links: