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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 1 to 10 of 22 results
Transmittal Number: VA-24-0023
State: Virginia
Summary: Removes provider appeals language from Page 90 and Attachment 7.5 pages one through seven of the Virginia State Medicaid Plan.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: SC-24-0013
State: South Carolina
Summary: This SPA proposes to add Intensive In-Home Services-Homebuilders to the South Carolina Rehabilitative Services Benefit.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Benefits
  • Reimbursement
Links:
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Transmittal Number: SC-24-0003
State: South Carolina
Summary: This amendment proposes to update the description of physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders to align with 42 CFR 440.110. It will also add coverage for medically necessary audiological services for members with full benefits who are ages 21 years and older.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Benefits
  • Other Licensed Practitioners
Links:
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Transmittal Number: VA-24-0010
State: Virginia
Summary: Allows entities licensed by the Department of Behavioral Health and Developmental Services as providers of case management services, specifically community services boards, to provide services under the brain injury services targeted case management (BIS TCM) program.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: SC-23-0015
State: South Carolina
Summary: This amendment proposes to add Multisystemic Therapy (MST) to the South Carolina Rehabilitative Services benefit.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Benefits
  • Reimbursement
  • Other Licensed Practitioners
Links:
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Transmittal Number: SC-23-0019
State: South Carolina
Summary: This amendment proposes to align the limitations on non-covered medical expenses with the current Medicaid coverage and benefits.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Benefits
  • Eligibility
Links:
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Transmittal Number: SC-23-0006
State: South Carolina
Summary: This amendment proposes to remove the limits previously applied to the Ambulatory Care annual visits. 
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Program Administration
Links:
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Transmittal Number: VA-23-0014
State: Virginia
Summary: This amendment provides reimbursement for services provided by licensed pharmacists, and pharmacy interns and pharmacy technicians supervised by phamacists, who are acting within their scope of practice or in a collaborative agreement with a provider licensed in Virginia or are specified in Board of Pharmacy protocols for licensure that have been reviewed and accepted by the Department of Medical Assistance Services and are services covered by Medicaid.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
  • Reimbursement
  • Vaccine
Links:
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Transmittal Number: SC-23-0008
State: South Carolina
Summary: This amendment proposes to implement the Assertive Community Treatment (ACT) team. The ACT utilizes a team treatment approach designed to provide comprehensive, community-based behavioral health treatment, rehabilitation, and support to persons with serious and persistent mental illness.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
Links:
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Transmittal Number: SC-23-0012
State: South Carolina
Summary: This amendment proposes to change services provided by county Substance Use Disorder (SUD) authorities under the oversight of the SC Department of Alcohol and Other Drug Abuse Services.
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Drugs and Related Services
  • Coverage
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT