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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 171 to 180 of 674 results
Transmittal Number: CA-22-0006
State: California
Summary: Adjusts rates for Radiological services so that they do not exceed 80% of the corresponding Medicare rate.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: CA-22-0022
State: California
Summary: Exempts Durable Medical Equipment (DME) Complex Rehabilitation Technology (CRT) and Complex Rehabilitation Technology Services (CRTS) from the ten percent payment reductions.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: CA-22-0009
State: California
Summary: Extends the Prop. 56 NEMT supplemental payments, effective January 1, 2022.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: CA-21-0020
State: California
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to reimburse Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs) and Tribal Federally Qualified Health Center (Tribal FQHCs) providers a supplemental amount for COVID-19 vaccine only visits.

 
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
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Transmittal Number: CA-21-0031
State: California
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the payment rates for the Habilitation – Community Living Arrangement Services (Licensed/Certified Residential Services) – Alternative Residential Model rate as a result of an increase to the state minimum wage.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: CA-21-0040
State: California
Summary: Rate increases for specified providers.
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Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: CA-21-0004
State: California
Summary: Extends the time-limited supplemental program for certain physician services past the previously approved sunset date of December 31, 2021.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: HI-21-0019
State: Hawaii
Summary: Removes the application of the routine cost limit and customary charge limit for cost reimbursement of distinct part nursing facilities of critical access hospitals.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: CA-21-0022
State: California
Summary: This SPA will add Kern and Sacramento Counties to the list of geographic areas offering Targeted Case Management (TCM) services for the "Children Under the Age of 21” TCM group.   

 
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: CA-21-0025
State: California
Summary: This SPA will add Merced County to the list of geographic areas offering Targeted Case Management (TCM) services for the "Individuals in Jeopardy of Negative Health or Psycho-Social Outcomes” TCM group.   

 
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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