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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 363 results
Transmittal Number: DC-19-008
State: District of Columbia
Summary: Updates the District's hospice care reimbursement methodology to align with federal requirements and enable the District to improve monitoring and oversight of the delivery of hospice services
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: DC-19-0007
State: District of Columbia
Summary: Renews the District of Columbia’s 1915(i) State Plan HCBS benefit
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Current State Plan
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Transmittal Number: NM-19-0019
State: New Mexico
Summary: Medicaid Drug Utilization Review (DUR)
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: NM-19-0014
State: New Mexico
Summary: Implements an increase in payment rates for hospital inpatient services effective July l, 2019. Reimbursement rates for inpatient hospital services increased by 14 percent for Safety Net Care Pool (SNCP) hospitals; five percent for the State Teaching Hospital; and 12 percent for all other in-state hospitals. Additionally, hospital outlier claims will be increased from 85 percent to 90 percent of the hospital's standardized cost
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NM-19-0011
State: New Mexico
Summary: Updates the dental reimbursement fee schedules
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Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NM-19-0017
State: New Mexico
Summary: Updates the telehealth and teleconsultation services reimbursement fee schedule
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: DC-19-0009
State: District of Columbia
Summary: Pharmacist Administration Services
Approval Date:
Effective Date:
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Transmittal Number: NM-19-0015
State: New Mexico
Summary: Updates the behavioral health fee schedule
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: DC-19-005
State: District of Columbia
Summary: This amendment will authorize the District to implement a PACE program, effective February 1, 2020 
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Current State Plan
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Transmittal Number: DC-19-0010
State: District of Columbia
Summary: Permits the District of Columbia Medicaid program to increase reimbursement rates for physical therapy, occupational therapy, and speech therapy services provided by home health agencies effective October 1, 2019
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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