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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 271 to 280 of 420 results
Transmittal Number: IN-15-003-MM3
State: Indiana
Summary: This SPA defines the new Alternative Benefit Package (ABP) for the new adult expansion group, for the Healthy Indiana Plan (HIP) Plus plan.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: DC-15-002
State: District of Columbia
Summary: Primary Care Rate Increase.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: IN-14-005
State: Indiana
Summary: Revises the reimbursement methodology for inpatient hospitals.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: IN-14-006
State: Indiana
Summary: Outpatient Hospital Assessment Fee.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: IN-15-008
State: Indiana
Summary: This amendment aligns the populations authorized through the State Plan versus 1115 waiver to include pregnant women eligible under 42 CFR 436.116, children eligible under 42 CFR 425.117 and 42 CFR 435.118, and presumptively eligible pregnant women.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Eligibility
Links:
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Transmittal Number: DC-15-001
State: District of Columbia
Summary: This SPA amendment will enable the District to extend Transitional Medicaid from two six month periods to one twelve month periodl; thus, enabling families with low incomes the opportunity to retain Medicaid without a lapse in coverage.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Eligibility
  • Program Administration
Links:
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Transmittal Number: DC-14-008
State: District of Columbia
Summary: Payment to General Hospital for Inpatient Hospital Services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DC-14-010
State: District of Columbia
Summary: Payment to specialty Hospital for Medical Services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: DC-14-011
State: District of Columbia
Summary: This SPA restructures and relocates language outlining provider cost reporting, auditing, and record maintenance requirements, as well as provider appeal rights.
Approval Date:
Effective Date:
Topics:
Links:
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Transmittal Number: DC-14-013
State: District of Columbia
Summary: Qualifications for Disproportionate Share Hospital.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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