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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 161 to 170 of 341 results
Transmittal Number: PR-20-0001
State: Puerto Rico
Summary: Allows Puerto Rico to cover MAVYRET, a Hepatitis C drug
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: OR-20-0008
State: Oregon
Summary: implement temporary changes to the Oregon 1915(k) Independent Choices Program related to Oregon’s response to the COVID 19 pandemic during the period of the Presidential and Secretarial emergency declarations (or any renewals thereof).
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
Links:
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Transmittal Number: OR-20-0009
State: Oregon
Summary: implement temporary changes to the Oregon 1915(j) Independent Choices Program related to Oregon’s response to the COVID 19 pandemic during the period of the Presidential and Secretarial emergency declarations (or any renewals thereof).
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
Links:
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Transmittal Number: OR-20-0005
State: Oregon
Summary: This SPA adds Lactation Consultant Services as a billable provider type
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: OR-20-0011
State: Oregon
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to expand telehealth, allow e-signatures to person-centered service plans in place of in-person ink signatures to minimize in person contact and allow verbal consent as authorization for providers to deliver services while awaiting receipt of the signed person-centered service plan, and allow certain home and community based services to be provided to individuals in inpatient settings.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
Links:
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Transmittal Number: PR-20-0002
State: Puerto Rico
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 cover the new optional group for COVID testing, impose less restrictive resource tests on certain eligibility groups, and to continue to consider residents who leave the Territory due to the disaster residents of the Territory.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Eligibility
Links:
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Transmittal Number: OR-20-0007
State: Oregon
Summary: Proposes a COVID-19 increase to nursing facility ventilator rates
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: OR-20-0006
State: Oregon
Summary: increased the telemedicine/Telehealth rates due to the COVID-19 Public Health Emergency (PHE) and will sunset at the end of the PHE.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: OR-19-0010
State: Oregon
Summary: revise the Behavioral Health rehabilitation and include a level of care for Intensive In-Home Behavioral Health Services as a part of Oregon’s services for children’s behavioral health.
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: OR-20-0001
State: Oregon
Summary: Adds clarifying language that the Department pays the PACE capitation rate based on a consumers Medicare status
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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