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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 12 results
Transmittal Number: OH-20-0007
State: Ohio
Summary: Updates the Attachment 4.19-B pages to obsolete the Outpatient Hospital Supplemental Payment Program
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Financing & Reimbursement
Links:
Transmittal Number: OH-20-0006
State: Ohio
Summary: Inpatient Hospital Services: Obsoleting Supplemental Upper Payment Limit
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: AZ-19-0004
State: Arizona
Summary: Proposes to authorize the state to enter outcome-based supplemental rebate agreements with drug manufacturers for drugs provided to the Medicaid program
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Prescription Drugs
Links:
Transmittal Number: PA-20-0002
State: Pennsylvania
Summary: Continues an additional class of disproportionate share hospital payment to qualifying hospitals that provide medical and surgical services for ocular disease and injuries
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
Transmittal Number: OK-19-0035
State: Oklahoma
Summary: Proposes a five percent (5%) increase to reimbursement rates for inpatient hospital services including: Diagnosis-related group inpatient hospitals, freestanding rehabilitation hospitals, and inpatient critical access hospitals
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: AL-20-0006
State: Alabama
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to increase reimbursement rates for Nursing Facilities during the COVID-19 state of emergency for all costs associated with staffing, supplies, social distancing standards, cleaning fees, etc. AL noted that this increase equates to approx. $20 per diem rate add-on payment for all NF's.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
Links:
Transmittal Number: PA-20-0003
State: Pennsylvania
Summary: Continues an additional class of disproportionate share hospital payment to qualifying facilities that promote access to comprehensive inpatient services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: AZ-20-0004
State: Arizona
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to allow physicians and other licensed practitioners, in accordance with state law, to order Medicaid Home Health services and to allow payments for a reserved bed to be made if the absence does not exceed 30 days per contract year.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Financing & Reimbursement
Links:
Transmittal Number: AZ-20-0003
State: Arizona
Summary: Updates nursing facility rates effective January 1, 2020
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
Transmittal Number: AL-20-0004
State: Alabama
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. In this amendment Alabama elects to suspend Medicaid copayments for all services for all Medicaid beneficiaries during the time of the Public Health emergency and to utilize telehealth for some Medicaid services.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Cost Sharing
Links: