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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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Transmittal Number: NC-23-0004-A
State: North Carolina
Summary: This amendment allows new providers time to obtain their accreditation through an approved accreditation organization thereby increasing access to services.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: NC-23-0003
State: North Carolina
Summary: This State Plan change is to increase Home Health Services Medicaid rates by ten percent (10%) above the rate in effect.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: DC-22-0014
State: District of Columbia
Summary: To adopt certain income disregards and make various eligibility-related updates to the state plan.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: NC-22-0035
State: North Carolina
Summary: This amendment modifies nursing facility service rates by adding a direct care facility stabilization add-on to the calculation of the per diem direct rate for existing and new facilities.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NC-22-0037
State: North Carolina
Summary: This SPA modifies the per member per month rate for medical home payments, specifically for primary care providers with assigned Tailored Care Management eligible beneficiaries.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NC-22-0004
State: North Carolina
Summary: This state plan amendment will allow Medicaid to move the authority for the per member per month enhanced management fees for primary care providers participating in the Carolina Access program from the Primary Care Case Management section of the state plan to the physician reimbursement section of the Medicaid State Plan.
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Reimbursement
Links:
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Transmittal Number: NC-22-0036
State: North Carolina
Summary: This state plan change is to increase the rates for psychiatric collaborative care and circumcision codes paid to

primary care Physicians, Nurse Practitioners and Physician Assistants
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NC-22-0015
State: North Carolina
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 Replace COVID Rates.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: NC-22-0016
State: North Carolina
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 implement a temporary non-HCBS COVID Rate Increase.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: NC-22-0017
State: North Carolina
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 implement a temporary non-HCBS COVID Rate Increase.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT