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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 435 results
Transmittal Number: AS-18-002
State: American Samoa
Summary: This authorizes the coverage and payment of Medically Necessary Durable Medical Equipment, Prosthetics, Orthotics and Supplies as part of the American Samoan Medicaid State Plan.
Approval Date:
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Topics:
  • Financing & Reimbursement
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Transmittal Number: NC-18-0002
State: North Carolina
Summary: This is to clarify definitions and procedures in the Estate Recovery Program.
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Effective Date:
Topics:
  • Program Administration
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Transmittal Number: NC-18-0003
State: North Carolina
Summary: This state plan amendment is submitted in order to allow all years of pre-graduate and post-graduate full-time Mental Health, Developmental Disability, and Substance Abuse Services (MH/DD/SAS) experience to apply to the qualifications required for MH/DD/SAS Qualified Professionals.
Approval Date:
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Topics:
  • Program Administration
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Transmittal Number: NC-18-0001
State: North Carolina
Summary: This state plan amendment was submitted in order change the metabolic formula reimbursement rate.
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Topics:
  • Financing & Reimbursement
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Transmittal Number: NC-17-0015
State: North Carolina
Summary: This SPA updates references to the Code of Federal Regulations (CFR) to be in compliance with 42 CFR 483, Subpart B.
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  • Program Administration
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Transmittal Number: NC-17-0016
State: North Carolina
Summary: The SPA submission requested to allow Clinical Pharmacist Practitioners to enroll directly as Medicaid Providers, which allows them to directly bill and to receive direct payment.
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Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: NC-17-0014
State: North Carolina
Summary: This SPA carve-out non-essential language that is reflected in the state's Clinical Coverage Policy 12B for HIV Case Management and to reflect changes made to provider requirements.
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  • Program Administration
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Transmittal Number: AS-17-002
State: American Samoa
Summary: Increases the encounter rate for FQHCs.
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Effective Date:
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  • Financing & Reimbursement
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Transmittal Number: NC-17-0006
State: North Carolina
Summary: This SPA adds Research-Based Intensive-Behavioral Health Treatment services for ages 0-21 to the state plan.
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Topics:
  • Benefits
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Transmittal Number: NC-17-0009
State: North Carolina
Summary: This SPA increases the reimbursement for personal care services from $3.47, to three dollars and eighty-eight cents ($3.88) effective August 1, 2017.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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