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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.

Results

Displaying 71 - 80 of 15853

New Hampshire

This amendment proposes to include coverage of the Medicaid reimbursement rate methodology for targeted case management services for eligible juveniles as defined by Section 1902(nn)(2) of the Social Security Act.

Approval Date: June 17, 2025
Effective Date: January 1, 2025
Topics: Alternative Benefit Plan Reimbursement Targeted Case Management

Vermont

This amendment proposes coverage limits for physician and PT/OT/ST services.

Approval Date: June 17, 2025
Effective Date: January 1, 2025
Topics: Alternative Benefit Plan Coverage

Oklahoma

This amendment reduces the SoonerSelect choice period from 60 days to 30 days, and to clarify that members covered under the SoonerPlan program for family planning visits are excluded from the ABP and SoonerSelect.

Approval Date: June 16, 2025
Effective Date: March 1, 2025
Topics: Alternative Benefit Plan

New Hampshire

This amendment proposes to provide targeted case management service coverage for Medicaid recipients with substance use disorder and to align with CMS Medically Unlikely Edit coding, effective January 1, 2025.

Approval Date: June 16, 2025
Effective Date: January 1, 2025
Topics: Coverage Preventive Services Reimbursement Targeted Case Management

South Dakota

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

Washington

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

Minnesota

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

New Mexico

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

Wyoming

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

Oregon

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025