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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: OR-20-0019
State: Oregon
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 continue the same stability payment rate method for Tribal 638 and Urban Indian Health programs into 2021 using the 2019, month actuals for 2020 and 202l until the PHE ends.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • reimbursement
Links:
Transmittal Number: OH-20-0016
State: Ohio
Summary: Includes the Ohio Department of Rehabilitation and Corrections in the list of qualified entities eligible to make Presumptive Eligibility (PE) determinations for Pregnant Women, Children, Adults, Parents or Caretaker Relatives, and the Former Foster Care Group.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
Transmittal Number: KS-20-0022
State: Kansas
Summary: Adds maternal depression screening to the benefits covered under the screening benefit category in Kansas’ State plan
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
Transmittal Number: GA-20-0003
State: Georgia
Summary: Ground Ambulance Upper Payment Limit (UPL) Supplemental Payment Program (Fee-For-Service)
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
Transmittal Number: MO-20-0024
State: Missouri
Summary: technical correction of web a address.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: KS-20-0020
State: Kansas
Summary: Updates the fee schedule to include a two-tiered reimbursement system for Emergency Room (ER) professional services.
Approval Date:
Effective Date:
Topics:
  • reimbursement
  • Program Administration
Links:
Transmittal Number: NC-20-0016
State: North Carolina
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 amend its state plan for four changes; three of which involve rate increases and an enhanced rate for NEMT providers during the PHE, and one providing authority to make quarterly payments to MRI/DSH/GAP payments to hospital providers.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • reimbursement
Links:
Transmittal Number: WA-20-0033
State: Washington
Summary: Removes add-on payment rate related to enhanced match due to COVID-19
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
Transmittal Number: FL-19-0010
State: Florida
Summary: Update the buy-back provisions for county health department reimbursement. 
Approval Date:
Effective Date:
Topics:
  • reimbursement
Links:
Transmittal Number: SC-18-0011
State: South Carolina
Summary: updates the base year used to determine payments under the Average Commercial Rate (ACR) method for the Supplemental Teaching Payment (STP) Program. It is also noted that this plan amendment excludes Greenville Hospital System (GHS), Palmetto Health Richland Hospital, and University of South Carolina College of Medicine d/b/a Prisma Health as eligible participants in the STP program.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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