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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.

Results

Displaying 311 - 320 of 15754

Wisconsin

This amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: January 2, 2025
Effective Date: December 31, 2024
Topics: Medicaid and CHIP Program (MACPro) Program Administration

Mississippi

This amendment grants authority to the appointed Executive Director to submit state plans on behalf of the Division of Medicaid, Office of the Governor, the single state agency.

Approval Date: December 30, 2024
Effective Date: October 11, 2024
Topics: Program Administration

Nebraska

Adding a new 1915 home and community-based services (HCBS) benefit, transmittal number NE-24-0005, titled Therapeutic Family Care Crisis Support Services program. CMS conducted the review of the state’s submittal according to statutory requirements in Title XIX of the Social Security Act and relevant federal regulations.

Approval Date: December 23, 2024
Effective Date: January 1, 2025
Topics: Home and community based services

Colorado

The Amendment Amends Colorado's State Plan to include Community First Choice (CFC) 1915 (k) (NEW).

Approval Date: December 23, 2024
Effective Date: July 1, 2025
Topics: Coverage Reimbursement

North Dakota

This State Plan Amendment updates state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15

Approval Date: December 20, 2024
Effective Date: December 31, 2024
Topics: Medicaid and CHIP Program (MACPro)

Colorado

This Amendment updates state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: December 20, 2024
Effective Date: December 1, 2024
Topics: Medicaid and CHIP Program (MACPro)

West Virginia

This amendment is to conduct Medicaid presumptive eligibility (PE) determinations. PE groups: children under age 19, parents and other caretaker relatives, pregnant women, adults, and former foster care children, the effective date is May 12, 2023. PE for individuals needing treatment for breast or cervical cancer, the effective date is January 1, 2023.

Approval Date: December 19, 2024
Effective Date: May 12, 2023
Topics: Coverage Eligibility Medicaid and CHIP Program (MACPro)

Arizona

This SPA amends the State plan to update Physician Administered Drug (PAD) reimbursement rates.

Approval Date: December 19, 2024
Effective Date: July 1, 2024
Topics: Physician Administered Drugs Prescribed Drugs Reimbursement

California

This SPA amendment, the state is implementing the final round of rate increases from a 2019 rate study, adding a new service called Person-Centered Future Planning, increasing the rate for Financial Management Services, and adding a new provider type to Community Living Arrangement Services.

Approval Date: December 19, 2024
Effective Date: January 1, 2025
Topics: Home and community based services

Virgin Islands

This amendment is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: December 19, 2024
Effective Date: December 1, 2024
Topics: Medicaid and CHIP Program (MACPro) Program Administration