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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 728 results
Transmittal Number: WA-21-0005
State: Washington
Summary: update to reimbursement rates for individual providers and agency providers
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: WA-21-0006
State: Washington
Summary: updated the fee schedule effective dates for several Medicaid programs and services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: WA-21-0009
State: Washington
Summary: Adds information regarding limitations on prosthetic devices provided under the Code of Federal Regulations at 42 CFR 440.70
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: WA-21-0004
State: Washington
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 provide an add-on payment to nursing facilities throughout the duration of the public health emergency.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: OR-21-0009
State: Oregon
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 add on a rate for Non Emergent Medical Transportation (NEMT) providers, to compensate for their wait times at drive through vaccination sites. The anticipated impact to beneficiaries for this SPA is neutral.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: OR-21-0005
State: Oregon
Summary: Effective March 1, 2021, this amendment clarifies access to Long-Term Care Community Nursing (LTCCN) services in all appropriate settings; removes the prohibition of using Physical Therapists and Occupational Therapists; increases the approval limit for Electronic Devices from $500 to $1,200; and, updates the Group Care Homes for Children (GCH) rate methodology. 
Approval Date:
Effective Date:
Topics:
  • Reimbursement
  • Financing & Reimbursement
  • Benefits
Links:
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Transmittal Number: WA-21-0008
State: Washington
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 allow the state to reimburse administration fees for COVID-19 vaccinations at the same rate as Medicare.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: WA-21-0010
State: Washington
Summary: Effective January 27, 2021, this amendment brings the state into compliance with a court order that instructs the state to cover medically necessary Applied Behavior Analysis (ABA) therapy to treat Autism Spectrum Disorder (ASD) for Medicaid Managed Care Organization (MCO) clients over the age of twenty and removes the limitation for managed care and fee-for-service enrollees in the Applied Behavior Analysis (ABA) therapy to treat Autism Spectrum Disorder (ASD.)
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
Links:
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Transmittal Number: OR-21-0006
State: Oregon
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 provide a 10% increase in payment rates for Adult Mental Health Residential, Substance Use Disorder Residential Programs, and Child and Adolescent Mental Health Residential providers.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: OR-21-0001
State: Oregon
Summary: Effective January 7, 2021, this amendment increases the daily encounter limit from one encounter per day to five encounters per day. This change applies to Indian Health Service and Tribal 638 clinics.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Indian Health Services
  • Program Administration
Links:
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