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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.

Results

Displaying 401 - 410 of 15696

Kansas

This Amendment to discontinue the OneCare Kansas, Health Home SMI, program as a covered service.

Approval Date: December 4, 2024
Effective Date: January 1, 2024
Topics: Medicaid and CHIP Program (MACPro)

Kansas

This Amendment to discontinue the OneCare Kansas, Health Home Asthma, program as a covered service.

Approval Date: December 4, 2024
Effective Date: January 1, 2025
Topics: Medicaid and CHIP Program (MACPro)

Kansas

This amendment adds an additional 2-year renewal of exemption from the Recovery Audit Contractor (RAC) program, from January 1, 2025, to December 31, 2026.

Approval Date: December 4, 2024
Effective Date: January 1, 2025
Topics: Program Administration

New Jersey

The state proposes changes to improve access to primary behavioral health services by allowing licensed clinical social workers, licensed professional counselors, and licensed marriage and family therapists to enroll as Medicaid fee-for-service providers and deliver behavioral health services permitted within the scope of their practice.

Approval Date: December 3, 2024
Effective Date: July 1, 2024
Topics: Coverage Other Licensed Practitioners Reimbursement

Illinois

This SPA makes certain technical changes to Illinois ' Medicaid State Plan.

Approval Date: December 3, 2024
Effective Date: July 1, 2024
Topics: Coverage and Reimbursement

Illinois

This amendment adds coverage of home-visiting services in order to provide informational support, screening, and care coordination to pregnant and parenting individuals and young children through pregnancy and beyond.

Approval Date: December 3, 2024
Effective Date: September 5, 2024
Topics: Coverage and Reimbursement

Puerto Rico

This SPA adds home health and hospice services for adults and updates the language under the Other Licensed Practitioners benefit. Additionally, the state clarified that benefits for the medically needy are the same as those for the categorically needy.

Approval Date: December 3, 2024
Effective Date: July 1, 2024
Topics: Benefits Coverage Home Health Other Licensed Practitioners

North Carolina

This plan amendment updates the Substance Abuse Intensive Outpatient Program (SAIOP) reimbursement rate.

Approval Date: December 3, 2024
Effective Date: August 1, 2024

Oregon

This amendment is submitted as part of the agency rate standardization project. The Oregon Health Authority will set the rate methodology for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) and Home Enteral/Parenteral Nutrition and IV Services under the Home Health state plan benefit at 80% of 2024 Medicare rate.

Approval Date: December 3, 2024
Effective Date: October 1, 2024
Topics: Coverage and Reimbursement

Maine

This plan amendment updates the payment methodology for dental services.

Approval Date: December 3, 2024
Effective Date: July 1, 2024