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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 91 - 100 of 15690

Hawaii

This amendment updates the fee schedule for services provided by the Child and Adolescent Mental Health Division
(CAMHD) and to modify the rehabilitative services language for peer support services.

Approval Date: March 26, 2025
Effective Date: December 28, 2024
Topics: Coverage and Reimbursement

Maine

This plan amendment updates the payment methodology for certain rehabilitative services.

Approval Date: March 26, 2025
Effective Date: July 1, 2022

Maine

This plan amendment updates the payment methodology for certain rehabilitative services.

Approval Date: March 26, 2025
Effective Date: January 1, 2024

New York

This SPA updates the reimbursement methodology of covered outpatient and prescribed drugs as well as physician administered drugs.

Approval Date: March 25, 2025
Effective Date: October 1, 2024
Topics: Covered Outpatient Drug Physician Administered Drugs Prescribed Drugs Reimbursement

Massachusetts

This plan amendment updates rates for Acute Outpatient Hospitals.

Approval Date: March 25, 2025
Effective Date: October 1, 2024

Iowa

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: March 24, 2025
Effective Date: December 1, 2024
Topics: Medicaid and CHIP Program (MACPro)

Louisiana

This amendment makes provisions governing the medical transportation program to establish guidelines for the administration and distribution of Elevated Level of Care (ELOC) services by non-emergency medical transportation (NEMT) vendors that meet the criteria to provide an ELOC service to Medical beneficiaries, and to clarify language regarding non-emergency medical ambulance transportation (NEAT) services.

Approval Date: March 24, 2025
Effective Date: October 20, 2024
Topics: Coverage and Reimbursement

Connecticut

This amendment is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Home Health Core Set(s) of measures.

Approval Date: March 21, 2025
Effective Date: October 1, 2024
Topics: Medicaid and CHIP Program (MACPro) Program Administration

New Hampshire

This amendment is to memorialize the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under New Hampshire's state plan.

Approval Date: March 21, 2025
Effective Date: January 1, 2025
Topics: Coverage Eligibility Medicaid and CHIP Program (MACPro)

Massachusetts

This amendment proposes to update the payment methodologies for Medicare crossover payments for certain Durable Medical Equipment services.

Approval Date: March 21, 2025
Effective Date: October 1, 2024
Topics: Medicaid-Medicare Issues Reimbursement