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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.

Results

Displaying 1 - 10 of 15780

Rhode Island

This plan amendment implements a legislative mandate to establish an additional Disproportionate Share Hospital (DSH) pool in the amount of $12.9 million, designated specifically for payments to government-owned and operated providers.

Approval Date: June 17, 2025
Effective Date: March 1, 2025

Oklahoma

This amendment reduces the SoonerSelect choice period from 60 days to 30 days, and to clarify that members covered under the SoonerPlan program for family planning visits are excluded from the ABP and SoonerSelect.

Approval Date: June 16, 2025
Effective Date: March 1, 2025
Topics: Alternative Benefit Plan

South Dakota

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

Washington

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

Minnesota

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

New Mexico

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

Wyoming

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

Oregon

This amendment proposes an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.

Approval Date: June 13, 2025
Effective Date: January 1, 2025

Rhode Island

This plan amendment makes technical changes to the cost-based reconciliation process and reporting requirements used to determine rates for psychiatric residential treatment facility (PRTF) services. It also transfers oversight authority for PRTFs from the Department of Children, Youth and Families to the state's Executive Office of Health and Human Services.

Approval Date: June 12, 2025
Effective Date: February 13, 2025

New York

This plan amendment provides additional payments to non-state government public residential health care facilities.

Approval Date: June 12, 2025
Effective Date: April 1, 2024