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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 141 to 150 of 180 results
Transmittal Number: AL-12-012
State: Alabama
Summary: This SPA discontinue coverage of legend (prescription only) brand and generic agents used for symptomatic relief of cough and cold. The Agency will continue to cover certain over-the-counter (OTC) cough and cold products in an effort to provide cost effective alternatives to recipients.
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Topics:
  • Benefits
  • Prescription Drugs
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Transmittal Number: AL-12-008
State: Alabama
Summary: Decreases Durable Medical Equipment (SME) provider reimbursement from 80% to 72% for Orthotics and Prosthetics.
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Transmittal Number: AL-12-010
State: Alabama
Summary: Discontinues coverage of eye classes and to clarifies language that outlines routine eye examples are provided, medically necessary.
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Transmittal Number: AL-11-021
State: Alabama
Summary: This SPA proposes to revise the payment methodology for nursing facility services. Specifically, the amendment proposes to provide an enhance payment of $120 per day to qualified nursing facilities for ventilator dependent or qualified tracheostomy services.
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Transmittal Number: AL-12-002
State: Alabama
Summary: Provides assurances that the State is in compliance with the screening and enrollment of providers.
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  • Program Administration
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Transmittal Number: AL-11-022
State: Alabama
Summary: Changes physician access payments.
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Topics:
  • Financing & Reimbursement
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Transmittal Number: AL-11-015
State: Alabama
Summary: Revises the payment methodology for inpatient and outpatient hospital services and other outpatient services for surgical procedures.
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Topics:
  • Financing & Reimbursement
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Transmittal Number: AL-11-010
State: Alabama
Summary: Adds in-home monitoring nursing services and equipment as a State plan covered service, removing it from the 1915 (b) waiver.
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Transmittal Number: AL-11-020
State: Alabama
Summary: This SPA is a response to a companion letter sent with approval package AL-11-011. This SPA proposes to remove language related to certain categories of prescription drugs and over -the counter products that do not meet the definition of a covered outpatient drug.
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Transmittal Number: AL-11-018
State: Alabama
Summary: Allows the Alabama Medicaid Agency to define services that an optometrist is legally authorized to perform as physicians' services.
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