An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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.
Summary: This amendment implements adjustments for Provider Preventable Conditions, consistent with Section 2702 of the Affordable Care Act of 2010 and the implementing final rule at 42 CFR 447 Subpart A.
Summary: This amendment proposes comprehensive changes to the reimbursement methodology for intermediate care facility for individuals with intellectual disability services from state owned and operated facilities.
Summary: This SPA will allow the state to use MAGI-based income methodologies for determining medically needy eligibility for pregnant women, children and caretaker relatives.
Summary: This SPA revises reimbursement for physicians and other practitioners who bill using the physician, psychologist or behavioral health clinician fee schedules to establish a separate fee for procedures that have an established Medicare facility fee using the same percentage difference as Medicare for facility based services.
Summary: This SPA proposes to add procedure code 90688 (influzenza virus vaccine, quadrivalent, split virus, when administered to individuals 19 years of age and older, for intermuscular use).
Summary: This SPA proposes to reimburse for specified services and vaccine administration provided under the Vaccines for Children program provided by certain primary care physicians at 100% of calculated 2014 Medicare facility and non-facility rates.
Summary: This SPA adjusts reimbursement to dental services, including; adding certain Current Physician Terminology codes to the dental fee schedule for radiology and oral and maxillofacial surgery.
