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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 161 to 170 of 525 results
Transmittal Number: GA-21-0008
State: Georgia
Summary: This plan amendment adds a three percent increase to 15 select dental codes. 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: GA-20-0010
State: Georgia
Summary: Effective August 14, 2020, this amendment creates a 1 percent rate increase for certain primary care codes. 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: GA-20-0008
State: Georgia
Summary: Effective for services beginning January 1, 2021, this amendment adds Silver Fluoride Diamine (HCPCS Code D1354) as a covered service. 
Approval Date:
Effective Date:
Topics:
  • Dental
  • Coverage
  • Benefits
Links:
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Transmittal Number: MI-21-0008
State: Michigan
Summary: Establishes the payment methodology for COVID-19 vaccine administration.
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Effective Date:
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Transmittal Number: MI-21-0007
State: Michigan
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to cover and set reimbursement rates for the administration of EUA monoclonal antibody COVID-19 treatment by authorized EMS providers to state defined eligible beneficiaries.
Approval Date:
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Topics:
  • Disaster Relief
  • Benefits
  • Reimbursement
Links:
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Transmittal Number: MI-21-1001
State: Michigan
Summary: adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid ABP state plan.
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Transmittal Number: MI-21-0005
State: Michigan
Summary: This amendment proposes to add medication assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. This letter is to inform you that Michigan’s Medicaid SPA TN 21-0005 is approved effective October 1, 2020 until September 30, 2025, pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Financing & Reimbursement
Links:
    SHARE THIS MEDICAID STATE PLAN AMENDMENT
    Transmittal Number: MI-21-0006
    State: Michigan
    Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to provide allow for a temporary premium payment to be paid to specified providers for in-person care and modifying the timeframe for accepting long term care facility annual cost reports.
    Approval Date:
    Effective Date:
    Topics:
    • Disaster Relief
    • Reimbursement
    Links:
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    Transmittal Number: GA-21-0004
    State: Georgia
    Summary: Effective July 1, 2021, this amendment revises the hospital auditing program to allow desk reviews/audits and focus reviews in lieu of on-site field audits. Current technology allows audits to be performed remotely instead of on-site or in-person.
    Approval Date:
    Effective Date:
    Topics:
    • Program Integrity
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    Transmittal Number: GA-20-0009
    State: Georgia
    Summary: Effective August 14, 2020, this amendment increases the reimbursement for ventilator dependent nursing facility residents. Specifically, this amendment proposes to increase the nursing facility per diem for a ventilator dependent resident by 3%. The rate will increase from $540.55 to $556.77. 
    Approval Date:
    Effective Date:
    Topics:
    • Reimbursement
    Links:
    SHARE THIS MEDICAID STATE PLAN AMENDMENT