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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: NY-09-63
State: New York
Summary: Pharmacists As lmmunizers.
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Transmittal Number: NY-05-26
State: New York
Summary: Outpatient UPL Payments Non-state Owned or Operated Government General Hospitals.
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Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NY-09-68
State: New York
Summary: Three Month Reduction in 2010 Trend Factor-Long Term Care.
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Effective Date:
Topics:
  • Program Administration
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Transmittal Number: MI-09-009
State: Michigan
Summary: Reimbursement for services provided in Special Health Care Needs Facilities.
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Effective Date:
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  • Financing & Reimbursement
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Transmittal Number: MI-09-008
State: Michigan
Summary: This SPA amends the Medicaid reimbursement component for Personal Care Services.
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  • Financing & Reimbursement
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Transmittal Number: MI-09-018
State: Michigan
Summary: This this amendment makes grammatical revisions to reimbursement methodology for special facilities for ventilator-dependent patients and facilities with specially placed patients transferred from an acute care hospital setting to an approved NF on a prior authorized basis.
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Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NY-09-52
State: New York
Summary: Dispense Brand Drugs When Less Expensive.
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Effective Date:
Topics:
  • Prescription Drugs
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Transmittal Number: MI-09-003
State: Michigan
Summary: This SPA proposes to place reasonable limits on the amounts of incurred necessary medical and remedial care expenses recognized under State law, but not covered under the State Plan.
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Topics:
  • Current State Plan
  • Program Administration
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Transmittal Number: NY-09-55
State: New York
Summary: CHIPRA Eligibility for Aliens & Pregnant Women.
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Effective Date:
Topics:
  • Benefits
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Transmittal Number: MI-09-013
State: Michigan
Summary: This amendment decreases payment rates to all hospitals by one percent, reduces a base year adjustment, eliminates payment for increased costs associated with a list of hospital acquired conditions, limits payments for certain child deliveries and adjust payment rates for an increase in costs for hearing tests.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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