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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 191 to 200 of 435 results
Transmittal Number: AS-12-007
State: American Samoa
Summary: Allows for the coverage of lawfully residing pregnant women and children under Section 214 of CHIPRA.
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: NC-17-003
State: North Carolina
Summary: Implements changes to the pharmacy reimbursement methodology for ingredient costs and the professional dispensing fees for clotting factor based on a survey of costs for Hemophilia Treatment Centers (HTCs) and non-HTCs.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
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Transmittal Number: AS-17-001
State: American Samoa
Summary: This amendment proposes coverage and reimbursement of emergency and certain other medical services furnished by off-island and out-of-country providers, effective April 1, 2017.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NC-11-058
State: North Carolina
Summary: This amendment originally proposed to remove the October 31, 2011 end of service date and thereby allow Child Development Services Agencies to continue to be reimbursed and cost settled for providing this service.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: NC-16-012
State: North Carolina
Summary: This amendment requires the base rate for Home Health Services remain the same as those in effect June 30, 2015.
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: NC-16-011
State: North Carolina
Summary: Freezes the diagnosis related group (DRG) base rate in effect as of June 30.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NC-16-010
State: North Carolina
Summary: Freezes the rates in effect as of June 30, 2015 for swing beds and lower level.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NC-16-008
State: North Carolina
Summary: Modifies the State's reimbursement methodology for setting payment rates for nursing facility services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NC-16-009
State: North Carolina
Summary: Modifies the State's reimbursement methodology for setting payment rates.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NC-16-013
State: North Carolina
Summary: Including references to the federally recognized tribes (Eastern Band of Cherokee Indians), where appropriate, to ensure all duties, roles and responsibilities previously assigned to county divisions of social services are shared with the tribe for individuals living within the tribal boundary.
Approval Date:
Effective Date:
Topics:
  • Tribal Issues
Links:
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