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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 291 to 300 of 531 results
Transmittal Number: WA-17-0022
State: Washington
Summary: Clarifies the personal care providers may not work more hours in a week than approved by Department of Social and HealthServices and the timing and approval process for person-centered service planning and program eligibility.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: WA-16-0005
State: Washington
Summary: Adds the ground medical transportation program.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: WA-17-0016
State: Washington
Summary: To implement a fee-for-service (FFS) Medicaid payment system for specialty mental health services provided to American Indian and Alaska Native (AI/AN) Medicaid enrollees. Currently, AI/AN enrollees must access specialty mental health services through a managed care system. SPA 17-0016 will allow mental health agencies to provide services to AI/AN enrollees on an FFS basis. AI/AN enrollees will have the choice to opt in to managed care mental health services or remain in the FFS system. Qualified mental health providers will be able to serve AI/AN enrollees and be paid through the FFS system.
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Transmittal Number: WA-17-0021
State: Washington
Summary: Personal Care Services.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: WA-17-0011
State: Washington
Summary: This SPA will allow charter schools and tribal schools to participate in the School Based Health Services (SBHS) Program.
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: WA-17-0013
State: Washington
Summary: This SPA amends current language under Attachment 4.22-A: Requirements for Third Party Liability - Identifying Liable Third Parties - diagnosis and trauma code edits to align with the Code of Federal Regulations 443.138
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: WA-17-0017
State: Washington
Summary: This SPA adds a reference to dentists as providers who are eligible to provide encounter services in Federally Qualified Health Centers (FQHC).
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
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Transmittal Number: WA-17-0009
State: Washington
Summary: This SPA implemented legislative mandated rates for home care agencies.
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Topics:
  • Financing & Reimbursement
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Transmittal Number: WA-17-0006
State: Washington
Summary: This SPA clarifies that the Department of Health (DOH) is the state agency that contracts with CMS to conduct surveys for non-long-term care health institutions and make recommendations for participation in the Medicare program.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: WA-17-0020
State: Washington
Summary: This SPA amends the limitations on prescription drug coverage to clarify that agents when used for cosmetic purposes or hair growth will only be covered when the state has determined that use to be medically necessary.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Program Administration
Links:
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