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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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Transmittal Number: DC-23-0014
State: District of Columbia
Summary: The purpose of this SPA is to carve out emergency transportation services from 1932(a) managed care contracts.
Approval Date:
Effective Date:
Topics:
  • Managed Care
Links:
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Transmittal Number: DC-23-0011
State: District of Columbia
Summary: To revise the rate rebasing schedules for Specialty Hospitals.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: DC-23-0015
State: District of Columbia
Summary: DESCRIPTION: Proposes several changes to update, clarify, and streamline language in the state plan. The proposed changes include: 1) streamlining language that describes certain therapy modalities, which are available under the Counseling/Therapy service benefit, 2) updating supervision requirements for behavioral health providers in Federally Qualified Health Centers (consistent with District Law), 3) clarifying education and experience requirements for credentialed staff able to provide State Plan rehabilitative services, and 4) updating rates for select behavioral health services according to the fee schedule.
Approval Date:
Effective Date:
Topics:
  • Preventative Services
Links:
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Transmittal Number: DC-23-0013
State: District of Columbia
Summary: This plan amendment to update rates for Mental Health Rehabilitative Services and Adult Substance Use Rehabilitative Services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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: DC-23-0010
State: District of Columbia
Summary: To expand the scope of covered transplant procedures to include small bowel and pancreas transplant procedures.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
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:
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Transmittal Number: WA-23-0050
State: Washington
Summary: This SPA proposes to bring Washington into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Approval Date:
Effective Date:
Topics:
  • Covered Outpatient Drug
  • Prescribed Drugs
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT