An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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.
Summary: This amendment proposed a resource disregard in order to increase the effective resource standards for all Medicaid eligibility groups subject to a resource test.
Summary: This amendment updates Medicaid State Plan language to ensure that responsible third-party payers (other than Medicare plans) are barred from refusing payment for an item or service solely because it did not receive prior authorization under the third-party payer's rules.
Summary: This amendment allows Partial Hospitalization Program (PHP) and Intensive Outpatient Treatment (IOP) of mental health disorders related to Eating Disorder Care.
Summary: This SPA allows coverage of medically necessary prescribed drugs that are not covered outpatient drugs, including drugs authorized for import by the U.S. Food and Drug Administration (FDA), during drug shortages. In addition, this SPA proposes to reimburse prescribed drugs that are not considered covered outpatient drugs utilizing the same methodologies as covered outpatient drugs.
Summary: This plan amendment updates the Critical Access Hospital (CAH) cost report settlements. These funds will be split between inpatient CAH Adjustment Factor (CAF) settlements and outpatient CAF settlements using the same percentage split as the inpatient and outpatient CAF settlements in 2013.
Summary: This SPA accept Medicaid eligibility decisions made by the Exchange or other agencies administering insurance affordability programs and to furnish Medicaid in to the same extent and in the same manner as if the applicant had been determined by the state to be eligible for Medicaid.
