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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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Showing 131 to 140 of 310 results
Transmittal Number: SD-18-005
State: South Dakota
Summary: This updates the payment pool amount for direct graduate medical education (GME) payments for in-state, private providers. In addition, it creates a new rural residency program for the Center for Family Medicine.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: SD-18-006
State: South Dakota
Summary: Reimbursement requirements in the Covered Outpatient Drugs.
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  • Financing & Reimbursement
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Transmittal Number: DE-18-0006
State: Delaware
Summary: Modifies Health Home proposal to expand the Assertive Community Integration Support Team (ACIST) program which supports individuals with Severe and Persistent Mental Illness (SPMI) and intellectual and developmental disabilities (I/DD).
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Topics:
  • Health Homes
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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.
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Topics:
  • Financing & Reimbursement
  • State Plan Factsheet
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Transmittal Number: DE-18-005
State: Delaware
Summary: This adds accreditation as an option to Medicare certification for Medicaid providers.
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Effective Date:
Topics:
  • Program Administration
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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.
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  • Financing & Reimbursement
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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.
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  • Financing & Reimbursement
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Transmittal Number: SD-18-003
State: South Dakota
Summary: This increases and also clarifies the reimbursement methodology for out of state specialty hospitals.
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Transmittal Number: DE-18-001
State: Delaware
Summary: Modifies the State Plan to establish coverage for targeted case management services for children and youth with serious emotional disturbance, mental health or substance use disorder or co-occurring mental health and substance use disorders
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Topics:
  • Program Administration
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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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