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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 241 to 250 of 843 results
Transmittal Number: MA-21-0036
State: Massachusetts
Summary: This amendment continues the rate year 2021 reimbursement methods and standards for acute and critical access

inpatient hospital services for one month, and effective November 1, 2021, establishes comprehensive changes for the duration of rate year 2022.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: MA-21-0038
State: Massachusetts
Summary: amends rate year ((RY) 2022 updates to reimbursement methods and standards for privately-owned psychiatric hospitals, and administrative updates only for substance abuse treatment hospitals.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: MA-22-0004
State: Massachusetts
Summary: Effective January 21, 2022 this amendment proposes to add coverage for acupuncture services.
Approval Date:
Effective Date:
Topics:
  • Coverage
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Transmittal Number: MA-22-0009
State: Massachusetts
Summary: to update the Standard Alternative Benefit Plan (ABP) to add clarifying Acupuncture & Urgent Care Clinics language.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
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Transmittal Number: MA-22-0010
State: Massachusetts
Summary: to update the CarePlus Alternative Benefit Plan (ABP) to add clarifying Acupuncture & Urgent Care Clinics language.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
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Transmittal Number: NC-22-0008
State: North Carolina
Summary: This state plan amendment allows North Carolina Medicaid to increase rates for Child/Adolescent Day Treatment, Community Support Team, High-Risk Intervention, Partial Hospitalization, Peer Support Services, Psychosocial Rehabilitation, Substance Abuse

Intensive Outpatient Treatment, and Substance Abuse Comprehensive Outpatient Treatment, as proposed in the HCBS Spending Plan.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: NC-22-0003
State: North Carolina
Summary: increases the percentage used to calculate rates for Certified Registered Nurse Anesthetists (CRNA) Services to 100% of North Carolinas’ Medicaid Physician Fee Schedule.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NC-22-0007
State: North Carolina
Summary: allows increase Medicaid Direct rates from the pre-COVID rate level for Private Duty Nursing service providers, enrolled in the Medicaid or NC Health Choice program. The new rate will be $11.25 per 15-minute unit.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: MA-22-0003
State: Massachusetts
Summary: revises nursing facility 2022 rate year reimbursement methods to establish new rate add-ons, amend existing rate add-ons, and further update certain COVID-19 related payments. The proposed amendment also includes reimbursement methodology to distribute state legislative appropriation in the amount of $25 million for workforce retention and recruitment initiatives.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: MA-22-0001
State: Massachusetts
Summary: Updates payments for certain Children’s Behavioral Health Services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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