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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 11 to 20 of 318 results
Transmittal Number: DE-24-0013
State: Delaware
Summary: The purpose of this amendment is to renew Delaware's 1915 State Plan HCBS benefit. The effective date for this renewal is January 1, 2025. This SPA is approved for five years expiring December 31, 2029, in accordance with 1915(7) of the Social Security Act.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Home and community based services
Links:
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Transmittal Number: NM-24-0004
State: New Mexico
Summary: This amendment is to establish coverage for doula services as a new reimbursable preventative service for individuals navigating pregnancy-related care adding coverage for lactation provider services as a new reimbursable preventative to increase access to education and management to prevent and solve breastfeeding problems and encourage support to breastfeeding mother-infant.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: NM-24-0002
State: New Mexico
Summary: This amendment is relating to an executive reorganization which will rename the Human Services Department (HSD) as the Health Care Authority (HCA). As a new executive department, HCA will administer laws and exercise functions relating to health care purchasing, policy, and regulation for the State of New Mexico.
Approval Date:
Effective Date:
Topics:
  • Medicaid and CHIP Program (MACPro)
Links:
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Transmittal Number: NM-24-0001
State: New Mexico
Summary: This amendment establishes coverage for Biomarker Tests that are medically necessary.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-24-0003
State: New Mexico
Summary: This amendment excludes ABLE accounts from Medicaid Estate Recovery (House Bill 98).
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-23-0017
State: New Mexico
Summary: This amendment adds chiropractic services and establishes a Medicaid reimbursement methodology.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: NM-23-0014
State: New Mexico
Summary: This amendment establishes Medicaid reimbursement for Rural Emergency Hospitals under the clinic benefit.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: DE-24-0008
State: Delaware
Summary: To add the role of pharmacist as a provider type.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
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Transmittal Number: DE-24-0007
State: Delaware
Summary: This amendment proposes removing the premiums requirement for participation in the Medicaid Workers with Disabilities (MWD) Program.
Approval Date:
Effective Date:
Topics:
  • Premiums
  • Program Administration
Links:
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Transmittal Number: DE-24-0010
State: Delaware
Summary: This SPA amends the State Plan to add coverage of prescribed drugs when medically necessary during drug shortages.
Approval Date:
Effective Date:
Topics:
  • Prescribed Drugs
  • Prescription Drugs
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT