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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 241 to 250 of 946 results
Transmittal Number: WA-21-0016-B
State: Washington
Summary: extended the temporary rate increase of 150 percent of the hospital's fee-for-service rates that was originally implemented effective July 1, 2018, which is now extended through June 30, 2023, to then be returned to the payment levels and methodology for these hospitals that were in place as of January 1, 2018.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: WA-21-0018
State: Washington
Summary: Managed Care Enrollment Process Update
Approval Date:
Effective Date:
Topics:
  • Outreach & Enrollment
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Transmittal Number: CT-21-0010
State: Connecticut
Summary: proposes updates to Attachments 3.1-A and 3.1-B of the Medicaid State Plan to update the Person-Centered Medical

Home Plus (PCMH+) program’s quality measures, which are used as part of the calculation methodology for the individual pool and challenge pool shared savings payments. These updates are necessary to reflect various changes to the measures by the applicable measure stewards. These changes include removing quality measures that have been retired, incorporating changes to the measures that have been made by the measure stewards, and updating measures to new stewards as appropriate.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: WA-21-0017
State: Washington
Summary: This SPA plans to implement changes to the inpatient psychiatric per diem rate for hospitals licensed under chapter as free-standing psychiatric hospitals providing long-term civil commitment services
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: WA-21-0024
State: Washington
Summary: Updated the fee schedule effective dates for several Medicaid programs and services.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: WA-21-0011
State: Washington
Summary: Allows the state to transfer the administrative functions and responsibilities of personal care and respite Individual Provider (IP) management from the Department of Social and Health Services (DSHS) and Area Agency on Aging (AAA) staff to a single contracted CDE vendor, the Consumer Direct Care Washington, LLC.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Financing & Reimbursement
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Transmittal Number: WA-21-0015
State: Washington
Summary: updates the current total amount of the Small Rural Disproportionate Share Hospital (SRDSH) “payment pool” through which SRDSH payments are made
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: CT-21-0017
State: Connecticut
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to remove the limit on the number of home and hospital bed leave days for which an ICF/IID can be paid in order to reserve the beds for when the individuals are able to return to the ICF/IID. This SPA also rescinds the flexibility approved in SPA CT-20-0015 that allowed PNMIs for adults to conduct only one random-moment time study (RMTS).
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
  • Benefits
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Transmittal Number: CT-21-0001-A
State: Connecticut
Summary: This SPA offers Medicaid eligibility pathway to certain individuals who meet the coverage requirements for the Connecticut Housing Engagement and Support Services (CHESS) Initiative State Plan Home and Community Based Services Benefit Pursuant to Section 1915(i) of the Social Security Act.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Home and community based services
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Transmittal Number: CT-21-0001
State: Connecticut
Summary: Effective August 6, 2021, this amendment adds the optional eligibility group of individuals who are eligible for state plan home and community-based services (HCBS) and meet the requirements for an approved section 1915(c) waiver. The amendment also offers a Medicaid eligibility pathway to certain individuals who meet the coverage requirements for the Connecticut Housing Engagement and Support Services (CHESS) Initiative State Plan Home and Community-Based Services Benefit Pursuant to Section 1915(i) of the Social Security Act. 
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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