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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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Transmittal Number: CA-09-020
State: California
Summary: The Weighted Average Medi-Cal Rate for Freestanding Skilled Nursing Facilities Level-B and Freestanding Subacute Skilled Nursing Facilities Level-B for the 2009-2010 and 2010-2011 Rate Years Shall Not Be Increased with Respect to the Weighted Average Medi-Cal Rate for the 2008 - 2009 Rate Year.
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Topics:
  • Financing & Reimbursement
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Transmittal Number: CA-10-015
State: California
Summary: Provides Various Changes to the Reimbursement Rate Setting Methodology for Freestanding Skilled Nursing Facilities Level-B and Freestanding Subacute Skilled Nursing Facilities Level-B, Effective August 1, 2010, Including a Life of a Rate Freeze for the 2010-2011 Rate Year, 3.93% Increase for the 2010-2011 Rate Year and a 2.4% Increase for the 2011-2012 Rate Year.
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Effective Date:
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Transmittal Number: CA-11-010
State: California
Summary: Reduces Reimbursement Rates for Following Long Term Care Facilities by 10% Effective June 1, 2011: Nursing Facilities - Level A and Distinct Part Nursing Facilities - Level B.
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Effective Date:
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Transmittal Number: CA-10-024
State: California
Summary: Implement 5% reduction in fee-for-service payments to pharmacies for Medi-Cal drug products.
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Effective Date:
Topics:
  • Program Administration
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Transmittal Number: CA-11-004
State: California
Summary: Third Party Liability - Threshold Amount Increase.
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Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: CA-10-026
State: California
Summary: Provides for Supplemental Payments, Funded by Intergovernmental Transfers, to Governmental Hospitals for Inpatient Hospital Services.
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  • Financing & Reimbursement
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Transmittal Number: VT-11-025
State: Vermont
Summary: This SPA transmitted a proposed amendment to Vermont's approved Title XIX State Plan to implement Section 2301 of theAffordable Care Act with respect to payment for free-standing birth center services.
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Topics:
  • Financing & Reimbursement
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Transmittal Number: CA-11-019
State: California
Summary: Expands Coverage of Nurse Practitioner Services to Authorize All Certified Nurse Practitioners to Bill Medi-Cal Independently Pursuant to State Legislation
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Topics:
  • Benefits
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Transmittal Number: CA-11-005
State: California
Summary: Adds in language regarding the Disproportionate Share Hospital audit and reporting requirements and the redistribution of DSH overpayments.
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  • Financing & Reimbursement
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Transmittal Number: VT-11-04
State: Vermont
Summary: Changes the methodology for updating nursing home rates quarterly for changes in acuity and resource needs during a traditional period while the State migrate from using the Vermont-specific RUG-III method of categorizing residents to the new Federal classification system known as RUG-IV which utilizes MDS 3.0.
Approval Date:
Effective Date:
Topics:
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