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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 101 to 110 of 284 results
Transmittal Number: SD-20-0007
State: South Dakota
Summary: implements inflationary rate increases appropriated by the state during the 2020 legislative session
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Current State Plan
Links:
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Transmittal Number: SD-20-0008
State: South Dakota
Summary: Implements a 2.0 percent inflationary increase to the Health Home per member per month (PMPM) payment.
Approval Date:
Effective Date:
Topics:
  • Health Homes
Links:
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Transmittal Number: WV-20-0001
State: West Virginia
Summary: update the definition of a chiropractor in the state plan and to allow for up to 20 combined visits of physical therapy, occupational therapy, and chiropractic services without a referral or prior authorization.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: SD-20-0006
State: South Dakota
Summary: Authorizes an annual, lump sum supplemental payment for qualifying, private nursing facilities.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: SD-20-0005
State: South Dakota
Summary: extends the supplemental payment for qualifying, private hospitals, for an

additional year.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: WV-20-0002
State: West Virginia
Summary: Updates the effective date of the fee schedules for dental, orthodontic and oral and maxillofacial Services.
Approval Date:
Effective Date:
Topics:
  • Dental
  • Program Administration
Links:
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Transmittal Number: WV-20-0004
State: West Virginia
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to make changes to eligibility, suspend most cost-sharing, adjust some existing benefits, expand telehealth flexibilities, and make certain payment changes.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Eligibility
  • Benefits
  • Reimbursement
Links:
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Transmittal Number: SD-20-0002
State: South Dakota
Summary: Provides separate reimbursement of high cost prescription drugs outside of the IHS/Tribal encounter rate
Approval Date:
Effective Date:
Topics:
  • Reimbursement
  • Prescription Drugs
Links:
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Transmittal Number: SD-20-0003
State: South Dakota
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to waive cost-sharing for testing services, testing-related services and treatments of COVID-19 and suspend the face-to-face requirements for community mental health centers.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Cost Sharing
  • Eligibility
  • Benefits
Links:
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Transmittal Number: WV-19-0005A
State: West Virginia
Summary: Allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L.115-271).
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT