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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: CT-20-0015
State: Connecticut
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 cover the new optional group for COVID testing, expand coverage to certain 1915, 1915(k), home health, laboratory and telehealth services, adjust prior authorizations for medications, and increase certain payment rates.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Prescription Drugs
  • reimbursement
Links:
Transmittal Number: WV-20-0004
State: West Virginia
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 changes to eligibility, suspend most cost-sharing, adjust some existing benefits, expand telehealth flexibilities, and make certain payment changes.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Eligibility
  • Benefits
  • reimbursement
Links:
Transmittal Number: DC-20-0003
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 temporarily modify the State Plan reimbursement methodology for FQHCs to establish a new alternative payment methodology (APM) as authorized in Section 1902(bb)(6) of the SSA.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
Links:
Transmittal Number: UT-20-0010
State: Utah
Summary: Reimbursement update for Outpatient Hospital Supplemental Payments
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: AZ-20-0006
State: Arizona
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 approve payments to certain nursing facility services providers.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
Links:
Transmittal Number: NM-20-0010
State: New Mexico
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 increase reimbursement to in-patient hospitals.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
Links:
Transmittal Number: OR-20-0015
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 allow retainer payments for certain services in 1915(k) state plan benefits.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
Links:
Transmittal Number: NY-19-0022
State: New York
Summary: authorizes supplemental payments for certain county operated diagnostic and treatment center services and mental hygiene clinics
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: VA-20-0006
State: Virginia
Summary: Recalculates the average commercial rate every three years
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: OR-20-0014
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 temporary increase rates for Ambulance ‘treat in place’ services during the public health emergency.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • reimbursement
Links:
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