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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 31 to 40 of 222 results
Transmittal Number: NM-22-0004
State: New Mexico
Summary: This amendment expands school-based health services (SBHS) under the Rehab benefit with the following services: 1) school health aide service; 2) developmental rehabilitative therapy (enhances existing service); 3) specialized transportation. The SPA also introduces a new reimbursement methodology for SBHS.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-22-0017
State: New Mexico
Summary: This SPA implements coverage of new mandatory benefits under Section 9811 of the American Rescue Plan (ARP).
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-23-0004
State: New Mexico
Summary: Effective May 12, 2023, New Mexico Medicaid is reimbursing pasteurized donor milk separately from the DRG in inpatient settings.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-23-0002
State: New Mexico
Summary: This amendment approved that the state will pay for prenatal genetic screening and prenatal fetal screening to determine if the fetus has the potential to born with a genetic condition or birth defect.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-22-0022
State: New Mexico
Summary: This SPA amendment is to add state plan language to prohibit age and dollar limits on services related to autism spectrum disorder.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-22-0023
State: New Mexico
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 implement a rate increase for providers of Personal Care Services (PCS) and Private Duty Nursing (PDN) services under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VI-22-0002
State: Virgin Islands
Summary: To remove the cash required to pay Part B premiums. VI will pay Part B premiums for all beneficiaries who also qualify for Medicare.
Approval Date:
Effective Date:
Topics:
  • Premiums
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-22-0021
State: New Mexico
Summary: New Mexico is updating its State Plan. Language is being added to clarify that telehealth and teleconsultation services are reimbursed at the same rate as face-to-face visits.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VI-22-0001
State: Virgin Islands
Summary: Increases the ABD resource limit for ABD and Medically Needy populations from $1,500 per person to $10,000.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VI-22-0005
State: Virgin Islands
Summary: Brings the territory into compliance with the requirements of Section 2302 of the Affordable Care Act (ACA) (concurrent care for children).
Approval Date:
Effective Date:
Topics:
  • Affordable Care Act
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT