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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: DC-14-014
State: District of Columbia
Summary: This SPA restructures and relocates language outlining provider preventable conditiona.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: DC-14-004
State: District of Columbia
Summary: Homeand Community+Base Service Option.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: NC-14-021
State: North Carolina
Summary: Revises the reimbursement of drugs reimbursed through the physician drug program.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Prescription Drugs
  • Program Administration
Links:
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Transmittal Number: NC-13-016
State: North Carolina
Summary: Freezes the rates for Targeted Case Management for Children and Adults with Serious Emotional Disturbance, or Severe and Persistent Mental Illness or Substance Abuse Disorder for State fiscal years 2014 and 2015.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: NC-13-017
State: North Carolina
Summary: Freezes rates for Targeted Case Management for Children and Adults with serious emotional disturbance or severe and persistent mental illness or substance abuse disorder.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: NC-13-015
State: North Carolina
Summary: Freezes the rates for Targeted Case Management for Adults and Children At-Risk for Abuse, Neglect, or Exploitation (ACRM) at the rate in effect on June 30, 2013, for State fiscal years 2014 and 2015.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: NC-14-0003-MM7
State: North Carolina
Summary: This SPA establishes that one or more qualified hospitals are determining presumptive eligibility, and that the state is providing coverage for individuals determined presumptively eligible, in accordance with the Affordable Care Act.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Eligibility
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Transmittal Number: NC-13-011
State: North Carolina
Summary: The amendment allows North Carolina to disregard compensation payments as income, resource, and asset made to individuals from the Eugenics Asexualization and Sterilization Compensation Program.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: DC-14-005
State: District of Columbia
Summary: Evidence-Based Mental Health Rehabilitation Services for Children.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
Links:
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Transmittal Number: DC-14-007
State: District of Columbia
Summary: Medicaid Organ Transplant Services.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
Links:
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