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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 8 of 8 results
Transmittal Number: NM-24-0004
State: New Mexico
Summary: This amendment is to establish coverage for doula services as a new reimbursable preventative service for individuals navigating pregnancy-related care adding coverage for lactation provider services as a new reimbursable preventative to increase access to education and management to prevent and solve breastfeeding problems and encourage support to breastfeeding mother-infant.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
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Transmittal Number: NM-24-0001
State: New Mexico
Summary: This amendment establishes coverage for Biomarker Tests that are medically necessary.
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Effective Date:
Topics:
  • Coverage and Reimbursement
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Transmittal Number: CT-24-0002
State: Connecticut
Summary: This amendment updates HCPCS reimbursement to physician office & outpatient/radiology/surgery, independent radiology, MEDS, lab, adult/children dental services, audiology/speech & language, ambulatory surgical centers, rehab/medical and behavioral health clinics. This SPA also updates reimbursement to physician admin drugs; adult complex skilled nursing services; long-acting reversible contraceptives (LARCs) and adds periodontal SRP services. It also extends rate add-ons for pediatric inpatient psych and the states person centered medical homes (PCMH+) program.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
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Transmittal Number: NM-23-0017
State: New Mexico
Summary: This amendment adds chiropractic services and establishes a Medicaid reimbursement methodology.
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Effective Date:
Topics:
  • Coverage and Reimbursement
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Transmittal Number: NM-23-0014
State: New Mexico
Summary: This amendment establishes Medicaid reimbursement for Rural Emergency Hospitals under the clinic benefit.
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Effective Date:
Topics:
  • Coverage and Reimbursement
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Transmittal Number: CT-22-0037
State: Connecticut
Summary: This amendment expands the coverage and payment for the use of Silver Diamine Fluoride (SDF) to all HUSKY Health (Medicaid) children and adults who receive dental services.
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Topics:
  • Coverage and Reimbursement
  • Dental
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Transmittal Number: CT-22-0028
State: Connecticut
Summary: This amendment looks to add coverage and reimbursement of Community Violence Prevention Services.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
  • Preventative Services
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Transmittal Number: CT-22-0020
State: Connecticut
Summary: his amendment establishes coverage and reimbursement for substance use services provided in outpatient and residential setting within the rehabilitative services category.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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