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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: NJ-22-0013
State: New Jersey
Summary: This SPA provides an update to New Jerseys SFY 2023 Graduate Medical Education (GME) Distribution Methodology.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NJ-22-0012
State: New Jersey
Summary: This SPA provides an update to New Jerseys SFY 2023 Graduate Medical Education (GME) Distribution Methodology.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: IN-22-0013
State: Indiana
Summary: This amendment assures compliance with electronic visit verification for personal care services as required by the 21^st^ Century Cures Act.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: IN-22-0011
State: Indiana
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to reimburse federally qualified health centers (FQHCs) and rural health clinics (RHCs) for the administration of the COVID-19 vaccines. This reimbursement would include a separate reimbursement for the administration of the COVID-19 vaccine in addition to the prospective payment system (PPS) rate for qualifying FQHC/RHC encounters.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: IN-22-0010
State: Indiana
Summary: Makes changes to reimburse Emergency Medical Services (EMS) providers for advanced life support services, basic life support services, and nonemergency medical transportation services within the providers' scope of practice at a rate that is comparable to the federal Medicare reimbursement rate for the service.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: IN-22-0012
State: Indiana
Summary: This State Plan Amendment (SPA) looks to provide Medicaid coverage for eligible members to receive general pediatric vaccine counseling as part of EPSDT. Beginning with dates of service on or after September 1, 2022, stand-alone general pediatric vaccination counseling as part of the early and periodic screening, diagnostic, and treatment (EPSDT) benefit will be reimbursed under CPT 99401 with modifier EP per the fee schedule. This SPA also relocates payment for Ambulance Response and Treat-no-Transport Services for Emergency Medical Technicians (EMT's) under the direction of a physician.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NJ-22-0016
State: New Jersey
Summary: This amendment was submitted in order to update the Medicaid Access Physician Services (MAPS) program.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NJ-22-0020
State: New Jersey
Summary: This amendment was submitted in order to update the Maternity Service rates to Clinicians and Community Doulas.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NJ-22-0019
State: New Jersey
Summary: This amendment was submitted in order to update the Private Duty Nursing rates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NJ-22-0018
State: New Jersey
Summary: Updates the Behavioral Health Service rates
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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