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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: MA-12-004
State: Massachusetts
Summary: This SPA terminates the State's 1616 agreement with the Social Security Administration.
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Transmittal Number: MA-11-016
State: Massachusetts
Summary: This SPA updates the inflation factors for operating costs between Hospital Rate Year (RY) 2011 and RY2012 (1.665%), and updates the base year for the outpatient payment amount per episode from RY2008 to RY2010.
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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.
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Topics:
  • Managed Care
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Transmittal Number: MA-11-005
State: Massachusetts
Summary: This amendment updates the reimbursement methodology for a private non-acute hospital that had no fewer than 500 beds as of June 30, 2007. Specifically it increases the payment rate by 4%.
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  • Financing & Reimbursement
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Transmittal Number: MA-10-014
State: Massachusetts
Summary: This amendment updates the methodology used to calculate payment rates for acute hospital outpatient services for hospital rate year 2011.
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Transmittal Number: MA-10-013
State: Massachusetts
Summary: This amendment updates the methodologies used to calculate payment rates for inpatient and outpatient hospital services.
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  • Financing & Reimbursement
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Transmittal Number: MA-12-001
State: Massachusetts
Summary: Incorporates Express Lane Eligibility Option for Children Receiving Medicaid.
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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).
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  • Eligibility
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Transmittal Number: MA-12-002
State: Massachusetts
Summary: Increases Cumulative Maximum Annual Copayment for Pharmacy Services from $200 to $250.
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Transmittal Number: MA-11-012
State: Massachusetts
Summary: This amendment proposes to implement Section 2702 of the Affordable Care.Act of 2010 and the implementing final rule at 42 CFR 447, Subpart A.
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Effective Date:
Topics:
  • Current State Plan
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