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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 191 to 200 of 748 results
Transmittal Number: MT-20-0027
State: Montana
Summary: Revises the Graduate Medical Education (GME) supplemental payment allocation to eligible hospitals.  
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: MT-20-0018
State: Montana
Summary: Nursing Facility reimbursement
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: SC-20-0008
State: South Carolina
Summary: This SPA includes reimbursement methods that use, among others, the National Average Drug Acquisition Cost (NADAC), plus a professional dispensing fee of $10.50 for covered outpatient drugs. This SPA also includes reimbursement rates for 340B drugs, long-term care and specialty drugs, drugs purchased at a nominal price, and physician administered drugs.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
  • Covered Outpatient Drug
Links:
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Transmittal Number: SC-20-0003
State: South Carolina
Summary: Allows for up to 12 months of systemic contraceptives to be provided per dispensation, pursuant to a prescription by a healthcare provider.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
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Transmittal Number: MT-20-0015
State: Montana
Summary: Effective for services on or after July 1, 2020, this amendment updates the fee schedule for Psychiatric Residential Treatment Facilities (PRTF) for state fiscal year 2020.   
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Financing & Reimbursement
Links:
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Transmittal Number: SC-20-0006
State: South Carolina
Summary: add reimbursement for Therapeutic Foster Care (TFC) and the corresponding billing code for use by Child Placing Agencies (CPAs) contracted with the South Carolina Department of Social Services (SCDSS)
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: MT-20-0005
State: Montana
Summary: apply a census income disregard for Medicaid eligibility groups subject to non-MAGI income methodology, and to migrate eligibility requirements already approved for those non-MAGI eligibility groups into the state plan. Additionally, this state plan amendment revises the MAGI

methodology to account for reasonably predictable 
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Eligibility
Links:
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Transmittal Number: MT-20-0013
State: Montana
Summary: Updates the date of the fee schedule for services
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: MT-20-0017
State: Montana
Summary: updates fee schedule reimbursement as of July 1, 2020 for autism treatment services
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: MT-20-0016
State: Montana
Summary: Change the maximum dispensing fee for each tier, to accurately reflect the provider rate increase appropriated by the Montana Legislature.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT