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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 141 to 150 of 409 results
Transmittal Number: NC-20-0008
State: North Carolina
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to eliminate all cost sharing for testing and treatment that may be COVID-19 related, suspend enrollment fees and monthly premiums for the Health Care for Workers with Disabilities (HCWD) program; allow increased payment rates of 5% to certain FFS programs; add a 5% additional rate increase to support specific providers who may be experiencing a disproportionate impact; set payment rates for telehealth; and add an interim payment methodology.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Cost Sharing
  • Premiums
  • Financing & Reimbursement
Links:
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Transmittal Number: NC-20-0002
State: North Carolina
Summary: Revises North Carolina’s End State Renal Disease (ESRD) program’s policies and titles to expand dialysis to patients diagnosed with Acute Kidney Injuries (AKI).
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: NC-20-0003
State: North Carolina
Summary: allow 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.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: NC-19-0007
State: North Carolina
Summary: Updates language to reflect PCCM changes in anticipation of statewide managed care delivery launch.
Approval Date:
Effective Date:
Topics:
  • Managed Care
Links:
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Transmittal Number: NC-19-0006
State: North Carolina
Summary: Allow Medicaid to add Peer Support as a service in the State Plan.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
Links:
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Transmittal Number: NC-19-0008
State: North Carolina
Summary: Allows Medicaid to change the State Maximum Allowable rate for Community Support Team services due to a change in the service definition.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Cost Sharing
Links:
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Transmittal Number: NC-19-0001
State: North Carolina
Summary: Increases reimbursement to the average commercial rate certain eligible medical providers described in the Medicaid state plan
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NC-19-0002
State: North Carolina
Summary: Removing Local Health Departments (LHD) Labs service payments.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NC-19-0003
State: North Carolina
Summary: Removing lab service payments for Local Health Departments.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NC-19-004
State: North Carolina
Summary: Migrates North Carolina Health Homes Services to terminate services offered in NC 11-050 Health Home Services which will be included in the approved NC Managed Care 1115 waiver.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT