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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 151 to 160 of 469 results
Transmittal Number: IL-21-0011
State: Illinois
Summary: This amendment proposes a series of increases to the reimbursement rate for facilities licensed by the Department of Public Health under the 

ID/DD Community Care Act as an ID/DD facility and medically complex for the developmentally disabled facilities licensed under the MC/DD Act.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: IL-20-0014
State: Illinois
Summary: Adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Benefits
Links:
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Transmittal Number: IL-21-0012
State: Illinois
Summary: Repeal of 3.5% rate reduction to reimbursement for hospital services effective with inpatient admissions and outpatient services on or after July 1, 2021.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: IL-21-0007
State: Illinois
Summary: Proposes to increase encounter rates for FQHCs
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: IL-21-0013
State: Illinois
Summary: Increases inpatient, per diem rate for safety-net hospitals to $630 for inpatient psychiatric services
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NM-21-0008
State: New Mexico
Summary: This plan amendment increases rates for the Family Infant Toddler (FIT) program. 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: IL-21-0010
State: Illinois
Summary: Proposes to make changes to post-eligibility treatment of income (PETI) by imposing reasonable limits on deductions for incurred medical or remedial care expenses
Approval Date:
Effective Date:
Topics:
  • Eligibility
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Transmittal Number: IL-21-0003
State: Illinois
Summary: Inpatient per diem rate increase for Illinois Children's Specialty Hospitals
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Financing & Reimbursement
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Transmittal Number: NM-21-0004
State: New Mexico
Summary: Effective October 1, 2020, this amendment adds the new mandatory MAT benefit 1905 (a)(29) in compliance with section 106(b) of the SUPPORT Act. MAT services include all FDA-approved or licensed drugs and biologicals to treat opioid use disorder (OUD), counseling services and behavioral therapy. These MAT services will provide necessary treatment for Medicaid beneficiaries with OUD and help address the national opioid epidemic. 
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: IL-21-0004
State: Illinois
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to cover COVID-19 vaccine administration using the Medicare Suburban Chicago FFS rate statewide and to recognize pharmacies and pharmacy professionals as qualified providers of COVID-19 vaccines per the HHS PREP Act.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Reimbursement
Links:
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