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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 131 to 140 of 488 results
Transmittal Number: IL-22-0007
State: Illinois
Summary: Ensures reimbursement methodology complies with applicable requirements for safety-net hospitals for obstetric services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: DC-21-0011
State: District of Columbia
Summary: 1915(i) - Supported Employment Services for Serious Mental Illness / Substance Use Disorder.
Approval Date:
Effective Date:
Topics:
  • Home and community based services
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Transmittal Number: IL-21-0020
State: Illinois
Summary: Updates the fee schedule for long-acting injectable medications administered in Inpatient Hospital psychiatric settings.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: DC-22-0003
State: District of Columbia
Summary: To add coverage to the District of Columbia’s Alternative Benefit Plan Medicaid Expansion, Routine Patient Cost in Qualifying Clinical Trials.
Approval Date:
Effective Date:
Topics:
  • Coverage
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Transmittal Number: IL-22-0005
State: Illinois
Summary: This amendment implement Sections 1905(a)(30) and 1905(gg) of the Social Security Act, which require coverage of routine patient costs associated with participation in qualifying clinical trials.
Approval Date:
Effective Date:
Topics:
  • Coverage
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Transmittal Number: DC-22-0002
State: District of Columbia
Summary:  To effectuate the coverage of routine patient costs incurred during qualified clinical trials from January 1, 2022 forward, as required by the Consolidated Appropriations Act, 2021, Division CC, Title II, Section 210.
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Effective Date:
Topics:
  • Coverage
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Transmittal Number: DC-21-0010
State: District of Columbia
Summary: To allow the District to transition its Section 1115 Behavioral Health Transformation Demonstration Program services to permanent State Plan authority in order to retain authority to provide Medicaid reimbursement.
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Effective Date:
Topics:
  • Coverage
  • Reimbursement
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Transmittal Number: IL-22-0006
State: Illinois
Summary: Updates rates for Occupational Therapy (OT).
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: IL-22-0004
State: Illinois
Summary: This amendment increases mental health rates for 2022.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: IL-21-0005
State: Illinois
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to set reimbursement for COVID-19 testing & vaccine administration to FQHCs/RHCs/ERCs.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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