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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 261 to 270 of 457 results
Transmittal Number: SC-17-0001
State: South Carolina
Summary: Allows for eligibility for certain pregnant women and children as described in section 1903(v)(4) and 2107 (e)(1)(J) of the Social Security Act and who are otherwise eligible for assistance under the state plan (template S89).
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Eligibility
  • Program Administration
Links:
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Transmittal Number: SC-17-0007
State: South Carolina
Summary: This SPA proposes to remove any reference to drugs used for cosmetic purposes or hair growth from the state plan pages.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Program Administration
Links:
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Transmittal Number: SC-16-0012
State: South Carolina
Summary: To continue complying with economy and efficiency as required by section 1902(a)(30) of the Social Security Act to an acceptable reimbursement methodology with regards to the Supplemental Teaching.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SC-16-0009
State: South Carolina
Summary: This SPA allows the exclusion of particular covered outpatient drugs, or class of drugs, from the managed care organization (MCO) model in those cases where they are not included in the MCO capitated rate.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SC-16-0002
State: South Carolina
Summary: Adds community integration service and therapeutic child care services to the South Carolina rehabilitativeservices benefit.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: NM-16-02
State: New Mexico
Summary: Establishes an alternate payment methodology for federally qualified health centers (FQHC) that train primarycare resident physicians.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: NM-16-009
State: New Mexico
Summary: Implements a five percent rate increase for Early and Periodic Screening, Diagnosis and Treatment screenings and various rate reductions for medical practitioner reimbursement.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NM-16-004
State: New Mexico
Summary: This amendment eliminates the Primary Care Provider Enhanced Payments.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NM-16-005
State: New Mexico
Summary: This amendment was submitted to implement a three percent rate reduction for outpatient hospital services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NM-16-006
State: New Mexico
Summary: This amendment was submitted to implement a five percent reduction for inpatient hospital rates, base rates, and capital pass through amounts.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT