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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 131 to 140 of 172 results
Transmittal Number: DE-13-001
State: Delaware
Summary: Coverage of barbituates and benzodiazepines for dual eligibles as a Medicare Part D drug and update quantity limits for opiod analgesics.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
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Transmittal Number: DE-12-014
State: Delaware
Summary: Payment methodology for Outpatient hospital services specifically Partical hospital psychiatric services and PPEC services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DE-12-013
State: Delaware
Summary: This SPA modifies reimbursement methodology for inpatient psychiatric services for children under 21.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DE-12-011
State: Delaware
Summary: Telemedicine delivery system for providers enrolled under Delaware Medicaid.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
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Transmittal Number: DE-12-010
State: Delaware
Summary: Survey and certification - change in administrative authority of the state long-term care ombudsman program.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: DE-12-012
State: Delaware
Summary: Reimbursement Methodology for ICF/MR Facilities.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DE-12-008
State: Delaware
Summary: Estate Recovery and Managed Care - Total Capitation Payment.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DE-12-009
State: Delaware
Summary: This SPA increases state plan nursing facility rates, including the Medicaid portion of a provider assessment on nursing facility bed days.
Approval Date:
Effective Date:
Topics:
  • Managed Care
Links:
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Transmittal Number: AS-12-006
State: American Samoa
Summary: Reimbursement of Medicare cost sharing expenses for dual eligible population.
Approval Date:
Effective Date:
Topics:
Links:
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Transmittal Number: DE-12-007
State: Delaware
Summary: Specifically, this SPA updates the income standard to 75% of the Federal Poverty Level (FPL) used in eligibility determinations for low income families with children under Section 1931 of the Social Security Act, and for children under age 21 under 42 CFR §435.222 for whom public agencies are assuming full or partial financial responsibility (e.g. foster children).
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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