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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.

Results

Displaying 131 - 140 of 15689

Wisconsin

This plan amendment proposes a payment methodology update to modify the cost reporting periods and rates methodology for new psychiatric, rehabilitation, or long-term care hospitals for Wisconsin's Inpatient and Outpatient Hospital State Plans.

Approval Date: March 10, 2025
Effective Date: November 1, 2024

Wisconsin

This plan amendment proposes to implement a reimbursement rate for CPT codes related to complex rehab technologies.

Approval Date: March 10, 2025
Effective Date: January 1, 2025

South Dakota

This amendment proposed a two-year extension of the exception from establishing a Medicaid Recovery Audit Contractor (RAC) program.

Approval Date: March 10, 2025
Effective Date: June 1, 2024
Topics: Program Administration

Wisconsin

The amendment added intensive outpatient treatment services.

Approval Date: March 10, 2025
Effective Date: November 1, 2024

Maryland

To expand coverage for school-based psychological services when provided to students who do not have an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP).

Approval Date: March 6, 2025
Effective Date: January 1, 2025

Nevada

This amendment authorizes the state to enter into value-based supplemental drug rebate agreements.

Approval Date: March 6, 2025
Effective Date: January 1, 2025
Topics: Value Based Purchasing

Massachusetts

This plan amendment updates Applied Behavior Therapy rates.

Approval Date: March 5, 2025
Effective Date: October 1, 2024

Massachusetts

This plan amendment updates Oxygen and Durable Medical Equipment rates.

Approval Date: March 5, 2025
Effective Date: October 1, 2024

Pennsylvania

Exception from the Medicaid Recovery Audit Contractor (RAC) requirements

Approval Date: March 5, 2025
Effective Date: June 1, 2025
Topics: Program Administration

Louisiana

This amendment allows provisions governing the Pharmacy Benefits Management Program to update the copay tier payment schedule to align with the U.S. Department of Health and Human Service, CMS, recommended guidelines.

Approval Date: March 5, 2025
Effective Date: December 20, 2024