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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 271 to 280 of 919 results
Transmittal Number: MA-21-0028
State: Massachusetts
Summary: This plan amendment provides updates to the methods and standards for setting payment rates for psychiatric day treatment services. 
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Topics:
  • Financing & Reimbursement
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Transmittal Number: CT-12-0021
State: Connecticut
Summary: This plan amendment makes the following changes: increases the rate for pediatric complex care skilled nursing services provided by home health agencies by 1.7%, reduces the rates for diabetic test strips and lancets on the medical/surgical supplies fee schedule to 100% of the current Medicare rates, and reduces specified soft quantity limits for certain procedure codes within the medical/surgical supplies, durable medical equipment (DME), and prosthetic/orthotic fee schedules. 
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Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: MA-21-0027
State: Massachusetts
Summary: This plan amendment provides updates to the payment rates for the personal care attendant program.
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Topics:
  • Financing & Reimbursement
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Transmittal Number: MA-21-0026
State: Massachusetts
Summary: Adds EPSDT preventative behavioral health services and established the methods and standards used to set payment rates.
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  • Financing & Reimbursement
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Transmittal Number: CT-21-0025
State: Connecticut
Summary: Increase inpatient per diem rates for private free-standing chronic disease and private psychiatric hospitals.
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  • Financing & Reimbursement
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Transmittal Number: CT-21-0026
State: Connecticut
Summary: Implements nursing facility rate increases for state fiscal years 2022 and 2023.
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  • Financing & Reimbursement
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Transmittal Number: MA-21-0031
State: Massachusetts
Summary: This SPA updates the providers who are able to prescribe or order durable medical equipment.
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Topics:
  • Coverage
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Transmittal Number: MA-21-0032
State: Massachusetts
Summary: Update the Standard Alternative Benefit Plan (ABP) to confirm coverage of Durable Medical Equipment (DME) services.
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  • Benefits
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Transmittal Number: MA-21-0030
State: Massachusetts
Summary: This amendment updates the state plan to reflect that Brokered Non ­Emergency Medical Transpo1iation (NEMT) Services are now provided through two Regional Transit Authorities. 
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Topics:
  • Current State Plan
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Transmittal Number: CT-21-0002
State: Connecticut
Summary: Updates the Alternative Benefit Plan (ABP) State Plan to include the CHESS program approved in SPA 21-0001 which improve housing stability and health outcomes for a targeted set of Medicaid members who meet specified needs-based criteria, including individuals who have complex health conditions, have experienced homelessness, and have been determined to be likely to benefit from targeted tenancy sustaining services based on risk factors.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT