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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 15849

Virginia

This SPA amends the Medicaid State Plan to provide for mandatory coverage in accordance with section 1902(a)(84)(D) of the Social Security Act for eligible juveniles who are incarcerated in a public institution post-adjudication of charges. This SPA is effective on January 1, 2025, and will sunset on December 31, 2026.

Approval Date: July 21, 2025
Effective Date: January 1, 2025
Topics: Coverage Eligibility Targeted Case Management

Kentucky

This SPA amends the Medicaid State Plan to provide for mandatory coverage in accordance with section 1902(a)(84)(D) of the Social Security Act for eligible juveniles who are incarcerated in a public institution post-adjudication of charges. This SPA is effective on January 1, 2025, and will sunset on December 31, 2026.

Approval Date: July 18, 2025
Effective Date: January 1, 2025
Topics: Coverage Eligibility Reimbursement Targeted Case Management

Mississippi

This amendment is to provide presumptive eligibility for pregnant women.

Approval Date: July 17, 2025
Effective Date: July 1, 2024
Topics: Coverage Eligibility Medicaid and CHIP Program (MACPro)

Wisconsin

The purpose of this SPA is to reflect exclusion of the following populations from mandatory managed care enrollment: bone marrow or stem cell transplant recipients and sickle cell disease (SCD) gene therapy recipients.

Approval Date: July 17, 2025
Effective Date: April 1, 2025

Mississippi

This amendment allows the Division of Medicaid (DOM) to remove prior authorization language and clarify details for inpatient referrals of physician specialist and inpatient hospital physician visit limits.

Approval Date: July 16, 2025
Effective Date: May 1, 2025
Topics: Coverage Inpatient Program Administration

Montana

This amendment adds provider types and certain supported employment services under the rehabilitative services benefit. The SPA also makes other minor changes to the state plan pages.

Approval Date: July 15, 2025
Effective Date: July 1, 2024
Topics: Coverage and Reimbursement

Massachusetts

This plan amendment updates reimbursement for inpatient acute hospital services for rate year 2025.

Approval Date: July 15, 2025
Effective Date: No Effective Date

Massachusetts

This plan amendment updates reimbursement for inpatient acute hospital services for rate year 2025.

Approval Date: July 15, 2025
Effective Date: No Effective Date

Massachusetts

This plan amendment updates reimbursement for inpatient acute hospital services for rate year 2025.

Approval Date: July 15, 2025
Effective Date: No Effective Date

American Samoa

This amendment invokes 1902(j) authority to exempt American Samoa from the requirements under 1902(a)(84)(D) of the Social Security Act.

Approval Date: July 11, 2025
Effective Date: January 1, 2025