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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 371 to 380 of 654 results
Transmittal Number: MT-15-0027
State: Montana
Summary: Implements Montana Health and Economic Livelihood Partnership Plan and provides ABP Essential Health Benefits, arranged by a Third Party Administrator to individuals in the new adult group with income between 51% -138% of the Federal Poverty Level.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: MT-15-0026
State: Montana
Summary: Implements Medicaid expansion and an alternative benefit plan for individuals in the new adult group with income under 50% of Federal Poverty Level, individuals who are medically frail, and individuals who live in a region, including and Indian reservation.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: MT-15-0035
State: Montana
Summary: Eliminates the limit of one pair of eyeglasses every 730 days and replace it with one pair of eyeglasses every 365 days.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: MT-15-0030
State: Montana
Summary: Establishes a $1,125 limit on dental treatment services for adults.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Dental
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Transmittal Number: MT-15-0034
State: Montana
Summary: Eliminates the limit of optometric eye exams from one exam every 730 days and change it to one exam every 365 days.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
Links:
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Transmittal Number: MT-15-0023
State: Montana
Summary: Removes nonprescription bronchosaline and nonprescription pyridoxine from the excludable-but-covered nonprescription drugs section of the prescribed drugs pages.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
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Transmittal Number: DC-14-012
State: District of Columbia
Summary: Establishes a lower level of reimbursement for short term services provided in psychiatric hospital for individuals under the age of 21.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: MT-15-0028
State: Montana
Summary: Incorporates reimbursement requirements for Hospice Care adopted in the federal Medicare regulations.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: MT-15-0033
State: Montana
Summary: Eliminates a 40-hour limitation per state fiscal year for occupational, physical and speech therapy services.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: DC-15-011
State: District of Columbia
Summary: This amendment will permanently extend existing provider increases for certain primary care services provided by qualified physicians. In addition, this SPA would extend the rate increase for the same services when provided by psychiatrists, obstetricians/gynecologists, and advanced practice registered nurses.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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