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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 231 to 240 of 971 results
Transmittal Number: MA-21-0036
State: Massachusetts
Summary: This amendment continues the rate year 2021 reimbursement methods and standards for acute and critical access

inpatient hospital services for one month, and effective November 1, 2021, establishes comprehensive changes for the duration of rate year 2022.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: LA-22-0002
State: Louisiana
Summary: Amends provisions governing reimbursement for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in order to establish an alternative payment methodology which would allow reimbursement outside of the

current Prospective Payment System rate for community health worker services provided in FQHCs and RHCs.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: MA-21-0038
State: Massachusetts
Summary: amends rate year ((RY) 2022 updates to reimbursement methods and standards for privately-owned psychiatric hospitals, and administrative updates only for substance abuse treatment hospitals.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: MA-22-0004
State: Massachusetts
Summary: Effective January 21, 2022 this amendment proposes to add coverage for acupuncture services.
Approval Date:
Effective Date:
Topics:
  • Coverage
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Transmittal Number: MA-22-0009
State: Massachusetts
Summary: to update the Standard Alternative Benefit Plan (ABP) to add clarifying Acupuncture & Urgent Care Clinics language.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
Links:
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Transmittal Number: MA-22-0010
State: Massachusetts
Summary: to update the CarePlus Alternative Benefit Plan (ABP) to add clarifying Acupuncture & Urgent Care Clinics language.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
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Transmittal Number: LA-22-0008
State: Louisiana
Summary: amends the provisions governing outpatient hospital services in order to provide reimbursement for laboratory testing for Coronavirus Disease 2019 (COVID-19) separately from outpatient hospital surgery fee schedule payments.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: MA-22-0003
State: Massachusetts
Summary: revises nursing facility 2022 rate year reimbursement methods to establish new rate add-ons, amend existing rate add-ons, and further update certain COVID-19 related payments. The proposed amendment also includes reimbursement methodology to distribute state legislative appropriation in the amount of $25 million for workforce retention and recruitment initiatives.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: LA-22-0012
State: Louisiana
Summary: This amendment proposes to implement coverage of routine patient costs associated with participation in qualifying clinical trials.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: LA-22-0006
State: Louisiana
Summary: This SPA is to amend the pharmacy pages provisions to cover select over the counter (OTC) medications.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
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