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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-19-0014
State: Nebraska
Summary: This state plan amendment establishes an Alternative Benefit Plan to serve persons eligible for Medicaid under Section 1902(a)(10)(A)(VIII) of the Social Security Act. This plan will offer Basic benefits equal to the current State Plan benefits offered in the state minus adult dental, vision, and over the counter drugs.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Eligibility
Links:
Transmittal Number: NE-19-0001
State: Nebraska
Summary: This state plan amendment establishes an Alternative Benefit Plan to serve persons eligible for Medicaid under Section 1902(a)(10)(A)(VIII) of the Social Security Act. This plan will offer Prime benefits equal to the current State Plan benefits offered in the state.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Dental
  • Eligibility
Links:
Transmittal Number: TN-18-0004
State: Tennessee
Summary: Updates to the paper application, and the state’s election to use an alternative single, streamlined application developed by the state for individuals applying for coverage who may be eligible based on the applicable modified adjusted gross income standard
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
Transmittal Number: UT-20-0002
State: Utah
Summary: Updates the reimbursement methodology for capital improvement incentive payments for intermediate care facilities for individuals with intellectual disabilities (ICF/IID).
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: ND-19-0006
State: North Dakota
Summary: Updates the state plan by extending the supplemental payment for critical access hospitals (CAHs) for an additional two-year period
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Financing & Reimbursement
Links:
Transmittal Number: IL-20-0005
State: Illinois
Summary: Changes to hospital inpatient and outpatient reimbursement 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: NY-14-0021
State: New York
Summary: Revises the reimbursement method for acute inpatient hospital rates
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: UT-20-0003
State: Utah
Summary: Updates the Durable Medical Equipment (DME) fee schedule.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
Transmittal Number: WI-20-0011
State: Wisconsin
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the cap for supplemental disproportionate hospital share (DHS) payments to qualifying hospital providers.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
Links:
Transmittal Number: MS-20-0011
State: Mississippi
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to waive all cost sharing for all beneficiaries, regardless of the ultimate diagnosis, for testing services and treatments for COVID-19, including vaccines, specialized equipment, and therapies.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Cost Sharing
Links:
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