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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: AL-12-013
State: Alabama
Summary: Increases Durable Medical Equipment (DME) provider reimbursement to 80% of Medicares allowed amount.
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Topics:
  • Financing & Reimbursement
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Transmittal Number: AL-12-017
State: Alabama
Summary: Removes the waiver of services related to the treatment of a terminal illness required when a beneficiary under the age of 21 elects hospice services.
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Transmittal Number: AL-12-013
State: Alabama
Summary: Increases Durable Medical Equipment (DME) provider reimbursement to 80% of Medicare's allowed amount.
Approval Date:
Effective Date:
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Transmittal Number: AL-12-016
State: Alabama
Summary: Establishs the provision of eyeglasses for adult beneficiaries.
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Effective Date:
Topics:
  • Benefits
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Transmittal Number: NY-12-16
State: New York
Summary: Proposes to reimburse Article 28 Clinics and private practitioners for lactation counseling services for pregnant and postpartum women when such services.
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Effective Date:
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Transmittal Number: NY-12-24
State: New York
Summary: Nursing Home Bedhold Revisions (effective 7/1/12) & Per Diem Adjustment (effective 12/1/12) (FMAP = 50%).
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Effective Date:
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  • Financing & Reimbursement
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Transmittal Number: NY-12-26
State: New York
Summary: OMH 2012/13 RTF Continuance of Rate (Freeze) & Revisions to OMH 2011/12 Residential Treatment Facilities (RTF) Drug Carve Out 1 Includes $31,250 for 9/1/12-9/30/12 and 2 $375,000 for 10/11/12-9/30/13 attributable to drug carve out. FMAP=50%).
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Financing & Reimbursement
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Transmittal Number: NY-11-62
State: New York
Summary: This SPA updates the wage equalization factor component of the service rates for the early intervention program and reduces the rates by five percent for these services on and after May 1, 2011.
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Transmittal Number: NY-12-10
State: New York
Summary: Proposes the implementation of Phase II counties for the State's Health Homes initiative.
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Transmittal Number: NY-12-11
State: New York
Summary: Proposes the implementation of Phase III counties for the State's Health Homes initiative.
Approval Date:
Effective Date:
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