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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.

Results

Displaying 161 - 170 of 15690

Nevada

This State Plan Amendment will increase the amount for the personal needs allowance to eligible recipients in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). This amendment will also allow for COLA increases annually.

Approval Date: February 27, 2025
Effective Date: January 16, 2025

Oklahoma

This amendment covers community health services to eligible members as provided by community health workers
(CHW) within a public health clinic.

Approval Date: February 27, 2025
Effective Date: January 1, 2025
Topics: Coverage and Reimbursement

Idaho

The Amendment adopts the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.

Approval Date: February 27, 2025
Effective Date: January 1, 2023
Topics: Medicaid and CHIP Program (MACPro)

Wyoming

This Amendment updates state plan assurances in
accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15. This SPA attests to Wyoming Medicaid's adherence with federal reporting requirements.

Approval Date: February 27, 2025
Effective Date: December 31, 2024
Topics: Medicaid and CHIP Program (MACPro)

New York

Assure compliance with annual mandatory Health Home core set reporting for the State of New York. This reporting includes all quality measure data for measures on the Health Home Core Set.

Approval Date: February 26, 2025
Effective Date: December 31, 2024

New York

Technical change to align with New York statute, which allows residents of Adult Care Facilities to receive both Hospice and Assisted Living Program services without having to disenroll from either, was originally approved on February 26, 2025.

Approval Date: February 26, 2025
Effective Date: November 1, 2024

New York

For NYS CCO/HHs Serving Individuals with I/DD to assure compliance to submit annual mandatory Health Home core set reporting for the State of New York. This reporting includes all quality measure data for the Health Home Core Set measures.

Approval Date: February 26, 2025
Effective Date: December 31, 2024

Florida

This amendment is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: February 26, 2025
Effective Date: October 1, 2024
Topics: Medicaid and CHIP Program (MACPro) Program Administration

Rhode Island

This amendment proposes to extend the current exemption to the Recovery Audit Contractors (RACs) requirement to have a vendor that identifies and corrects improper Medicaid payments through the collection of overpayments and reimbursement of underpayments.

Approval Date: February 26, 2025
Effective Date: August 5, 2024
Topics: Program Administration

Tennessee

This amendment updates the allowance for personal needs for institutionalized individuals and couples.

Approval Date: February 26, 2025
Effective Date: January 1, 2025