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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 15 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: 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: OK-20-0012
State: Oklahoma
Summary: increase the number of covered inpatient rehabilitation hospital days for adult SoonerCare members from 24 days per state fiscal year to 90 days per state fiscal year
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Current State Plan
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OK-20-0021
State: Oklahoma
Summary: Separates and differentiates between services provided in a school setting under EPSDT versus those school-based services provided pursuant to an Individual Education Plan (IEP).
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Current State Plan
  • Benefits
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OK-20-0006
State: Oklahoma
Summary: This SPA allows a nurse's license to be portable between member states of the compact to increase access to care by allowing nurses to practice in other states without obtaining additional licenses
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Current State Plan
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
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:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
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:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
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:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OK-20-0011
State: Oklahoma
Summary: To include pancreas and intestinal transplants as covered organ and tissue transplant procedures.  It also updated transplant standards to include donor search and procurement services and to ensure that the methods used for organ acquisition are consistent with the Medicare program
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Program Administration
  • Current State Plan
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OK-19-040
State: Oklahoma
Summary: Proposes to allow the state 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).
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Current State Plan
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT