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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 1 to 10 of 10 results
Transmittal Number: WA-21-0022
State: Washington
Summary: To remove information related to a "Reasonable Eligibility Period" eligibility pilot that the state implemented from July 1, 2018, through June 30, 2019. SPA 21-0022 will remove the pilot information from the Medicaid State Plan.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
Links:
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Transmittal Number: MT-20-0015
State: Montana
Summary: Effective for services on or after July 1, 2020, this amendment updates the fee schedule for Psychiatric Residential Treatment Facilities (PRTF) for state fiscal year 2020.   
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Financing & Reimbursement
Links:
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Transmittal Number: WA-20-0015
State: Washington
Summary: extends the provisions for rate enhancement for low volume, small rural hospitals
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Program Administration
Links:
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Transmittal Number: WA-20-0011
State: Washington
Summary: Makes changes to the 1915(k) Community First Choice state plan option to include changes related to Washington's response to the COVID-19 outbreak.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Disaster Relief
Links:
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Transmittal Number: WA-20-0012
State: Washington
Summary:  This SPA amends the Specialized Services section in the State Plan to note that specialized services delivered at the facility or those that take the resident into the community may be suspended due to a state or federal national emergency.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Current State Plan
Links:
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Transmittal Number: WA-20-0010
State: Washington
Summary: Updates the payment for professional services in case of a governor-declared state emergency (such as the current COVID-19 outbreak), when the Medicaid agency determines it is appropriate. This SPA also ensures payment for professional services provided via telephone services and /or online digital evaluation and management services at the same rates as for professional services provided face-to-face or via telemedicine, to support the delivery of health care services during a state of emergency.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Disaster Relief
  • Benefits
  • Program Administration
Links:
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Transmittal Number: WA-20-0004
State: Washington
Summary: Updates language clarifying the approved place of service for School-Based Health Care Services and adds Advanced Registered Nurse Practitioners as a new provider type.
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Current State Plan
Links:
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Transmittal Number: MT-19-0001
State: Montana
Summary: Proposes to allow the Division of Medicaid to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder

Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271). This amendment also proposes to allow the Division of Medicaid to comply with the requirements outlined in Montana House Bill 86 regarding a 7-day supply limit for opioid naïve members
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Current State Plan
Links:
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Transmittal Number: MT-15-0021
State: Montana
Summary: Added introduction page.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
Links:
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Transmittal Number: MT-08-016
State: Montana
Summary: Target Case Management for Chronically Mentally Ill Adults.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
Links:
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