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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: TX-20-0010
State: Texas
Summary: This amendment proposes to revise the Texas State plan to incorporate language that authorizes the state to negotiate value-based purchasing arrangements with drug manufacturers.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Benefits
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Transmittal Number: DC-20-0006
State: District of Columbia
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 permit the District of Columbia Medicaid program to make retainer payments to Adult Day Health Program (ADHP) providers whose operations have been impacted by the ongoing public health crisis related to COVID-19.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
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Transmittal Number: DE-20-0006
State: Delaware
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 make 3 episodes of 30 consecutive days of retainer payments to providers of 1915 Pathways to Employment supported employment services. The state also temporarily increases the rate paid to providers by 5%
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
  • Benefits
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Transmittal Number: OK-20-0033
State: Oklahoma
Summary: revises the rate methodology for new Certified Community Behavioral Health (CCBH) service providers
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Effective Date:
Topics:
  • Program Administration
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Transmittal Number: MA-20-0012
State: Massachusetts
Summary: provides an emergency increase to the rates for home health services to implement chapter 142 of the act of 2019
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Transmittal Number: IL-20-0007
State: Illinois
Summary: ICF/DD wage increase
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: MA-20-0013
State: Massachusetts
Summary: Updates methods used to determine rates of payment for acute inpatient hospital services
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: OH-20-0015
State: Ohio
Summary: amended to disregard temporary decennial census income for Non-MAGI eligibility groups by applying less restrictive income methodologies
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Program Administration
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Transmittal Number: AR-20-0019
State: Arkansas
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 modify the other licensed practitioner benefit to allow licensed pharmacists within their state scope of practice with CLIA waiver certification to provide diagnostic COVID-19 antigen tests; and to reimburse pharmacists providing COVID testing using a state-developed fee schedule for diagnostic testing.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Financing & Reimbursement
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Transmittal Number: ME-20-0023
State: Maine
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 include additional coverage and payment for COVID-19 testing, add teledentistry to telehealth benefits, add publicly-owned hospitals to those eligible to receive supplemental payments, and to add qualifications for direct support professionals, mental health rehabilitation technicians and behavioral health professionals.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Financing & Reimbursement
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