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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 61 to 70 of 531 results
Transmittal Number: WA-24-0010
State: Washington
Summary: Uniform Cost Reporting Update
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-24-0006
State: Washington
Summary: This amendment is to increase the total compensated amount on all claim types to $250.00 in accordance with Title 42, Chapter IV, Subchapter C, Part 433 of the Code of Federal Regulations.
Approval Date:
Effective Date:
Topics:
  • Third Party Liability
Links:
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Transmittal Number: WA-23-0046
State: Washington
Summary: This SPA removed Fee-for-Service supplemental payments for safety net programs and moved the payments to state directed payments under managed care.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: PR-23-0003
State: Puerto Rico
Summary: This amendment proposed to elect use of the Federal Poverty Level in determining income eligibility under Puerto Rico's State Plan. 
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: PR-23-0009
State: Puerto Rico
Summary: Proposes eliminating all cost-sharing except for copays associated with pharmacy and non-emergency use of the Emergency Room.
Approval Date:
Effective Date:
Topics:
  • Cost Sharing
Links:
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Transmittal Number: WA-23-0048
State: Washington
Summary: This amendment is to comply with Section 1940 (42CFR 1396w) of the Social Security Act by contracting with vendors who specialize in automated financial institution verification for Medicaid agencies and check the financial resources of Medicaid applicants/recipients.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: PR-23-0006
State: Puerto Rico
Summary: This SPA proposes to bring Puerto Rico into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
  • Covered Outpatient Drug
  • Prescribed Drugs
  • Specialty Drugs
Links:
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Transmittal Number: WA-23-0033
State: Washington
Summary: This SPA updated the rates for outpatient Sole Community Hospitals.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-0029
State: Washington
Summary: The purpose is to updates the services payable in addition to the Administrative Day rate.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-2014-2
State: Washington
Summary: This amendment is to expand the Oral Health Connections Pilot project until December 31, 2023, modifying the age range for pregnant clients from 21 to 64, to, 16 and older, and changing the age range for diabetic customers from 21 to 64, to, 21 and older. Clients who were qualified for both Medicaid and Medicare (dual eligibles) will also be able to participate.
Approval Date:
Effective Date:
Topics:
  • ABP
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT