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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 21 to 30 of 445 results
Transmittal Number: IA-24-0004
State: Iowa
Summary: This SPA updates the case-mix weights from RUGS III to PDPM and eliminates semi-annual updates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WY-24-0003
State: Wyoming
Summary: This amendment is to ensure all minimum requirements outlined in Section 1902(a)(87) of the Social Security Act are met.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: WY-24-0002
State: Wyoming
Summary: This amendment is to add Psychosocial Rehabilitation - Clubhouse services to the Rehabilitation Services section of the Wyoming State Plan.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: IA-23-0023
State: Iowa
Summary: With this amendment, the state will permanently adopt COVID-19 PHE flexibilities; and add Remote Supports & Host Home Service modalities to align with the state's 1915(c) HCBS waivers.
Approval Date:
Effective Date:
Topics:
  • Home and community based services
Links:
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Transmittal Number: IA-24-0001
State: Iowa
Summary: This plan amendment implements the tri-annual outpatient hospital rate rebase.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WY-24-0001
State: Wyoming
Summary: This amendment updates the coverage of preventive services when recommended by a physician or other licensed practitioner.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: IA-23-0011
State: Iowa
Summary: This amendment is to eliminate the Dental Healthy Behaviors requirement and remove the basic dental benefit package from the Alternative Benefit Plan (ABP).
Approval Date:
Effective Date:
Topics:
  • ABP
Links:
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Transmittal Number: IA-23-0026
State: Iowa
Summary: This amendment complies with the federal requirement that the state implement a tracking system that ensures that cost sharing and premiums of a Medicaid beneficiary will not exceed five percent of the family income.
Approval Date:
Effective Date:
Topics:
  • Premiums
  • Cost Sharing
Links:
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Transmittal Number: IA-23-0012
State: Iowa
Summary: This amendment eliminates the Dental Healthy Behaviors requirement and remove the basic dental benefit package from the Iowa Dental Wellness Plan.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: IA-23-0021
State: Iowa
Summary: This plan amendment is an enhanced fee schedule (dental) provided in Iowa non-state-own dentistry clinics located in county with a population over 350,000.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT