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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 121 to 130 of 441 results
Transmittal Number: NM-22-0012
State: New Mexico
Summary: Implemented an addon rate for NF ventilator services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: OR-22-0008
State: Oregon
Summary: This SPA provides Oregon with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in Medicaid program.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: OR-22-0009
State: Oregon
Summary: Continue this reimbursement past the PHE as reflected in this SPA. The Medicaid payment rate will continue to be is $60 per session.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: OR-22-0007
State: Oregon
Summary: This Alternative Benefit Plan amendment is to comply to the Consolidated Appropriations Act for 2021, which amended the Medicaid statute to add as a mandatory benefit, in both state plan and benchmark and benchmark equivalent coverage, for “routine patient costs for items and services furnished in connection with a qualifying clinical trial.”
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
Links:
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Transmittal Number: OR-22-0010
State: Oregon
Summary: This amendment is in compliance with specific third party liability requirements outlined in the Bipartisan Budget Act of 2018 and the Medicaid Services Investment and Accountability Act of 2019.
Approval Date:
Effective Date:
Topics:
  • Third Party Liability
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Transmittal Number: OR-22-0005
State: Oregon
Summary: Increases the rate for professional components for neonatal and pediatric ICU procedure codes: 99468-99480.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NM-22-0009
State: New Mexico
Summary: This SPA amends to add coverage of routine patient costs associated with participation in qualifying clinical trials to conform with the new regulatory requirements of 1905(a)(30) and 1905(gg) of the Social Security Act (SSA).
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: OR-22-0003
State: Oregon
Summary: increased the hourly rate for Applied Behavioral Analysis (ABA) to $55.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: OR-22-0006
State: Oregon
Summary: This amendment was to comply with the Consolidated Appropriations Act for 2021, which amended the Medicaid statute to add as a mandatory benefit, in both state plan and benchmark and benchmark equivalent coverage, for “routine patient costs for items and services furnished in connection with a qualifying clinical trial.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: NM-22-0006
State: New Mexico
Summary: This amendment is to update the state plan to ensure compliance with federal Preadmission Screening and Resident Review (PASRR) requirements.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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