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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 43 results
Transmittal Number: DE-21-0008
State: Delaware
Summary: This plan amendment adds reimbursement methodology for an ambulatory surgical center being used to provide dental services.  
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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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
Links:
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Transmittal Number: DE-20-0002
State: Delaware
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend all copayments and premiums for all beneficiaries, modify telehealth benefits and allow payment accordingly, adjust the day supply or quantity limit for covered outpatient drugs, expand Prior authorization for medications automatic renewal without clinical review, or time/quantity extensions, and make exceptions to their published Preferred Drug List if drug shortages occur.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Cost Sharing
  • Premiums
  • Benefits
  • Financing & Reimbursement
  • Prescription Drugs
Links:
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Transmittal Number: DE-19-007
State: Delaware
Summary: Adds facilities to which originating site fees can be paid, specifically Federally Qualified Health Centers and School Based Wellness Centers, for telemedicine services
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Benefits
Links:
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Transmittal Number: DE-19-001
State: Delaware
Summary: Removes annual numerical limitations placed on chiropractic care visits for the purpose of treating back pain.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DE-18-004
State: Delaware
Summary: Modifies the State Plan to grant Delaware an exception to the Recovery Audit Contracting (RAC) requirements.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • State Plan Factsheet
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Transmittal Number: DE-18-007
State: Delaware
Summary: This modifies the State Plan to identify Delaware's Asset Verification System (AVS) vendor, Public Consulting Group, Inc.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DE-18-002
State: Delaware
Summary: This amendment modifies the State Plan to update Delaware's current Federally Qualified Health Center (FQHC) reimbursement policy to better align with the costs of operating Delaware FQHCs.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DE-17-009
State: Delaware
Summary: This amendment reduces Delaware Medicaid reimbursement rates for dental services by 14%.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DE-17-012
State: Delaware
Summary: Reimbursement to out-of-state PRTFs to include a negotiated rate.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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