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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 151 to 160 of 382 results
Transmittal Number: HI-21-0001
State: Hawaii
Summary: Effective January 1, 2021, this amendment increases the monthly income standards for Domiciliary Care. 
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Financing & Reimbursement
Links:
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Transmittal Number: HI-21-0006
State: Hawaii
Summary: Effective January 13, 2021, this amendment increases the component prices for private nursing facility rates by 12 percent. 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: MS-20-0024
State: Mississippi
Summary: Physician Upper Payment Limit (UPL) is amended to allow the Division of Medicaid to update the initial Medicare equivalent of the average commercial rate (ACR) ratio.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: MS-20-0028
State: Mississippi
Summary: allows the Division of Medicaid (DOM) to address the pricing of new Code on Dental Procedures and Nomenclature (CDT) codes.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: MS-20-0026
State: Mississippi
Summary: Replaces the Attorney General Certificate with the signature of the current Attorney General, Lynn Fitch.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: HI-20-0003
State: Hawaii
Summary: Updates the fee schedule methodology for EPSDT, Home Pharmacy Services, Medical Supplies, and Dental services in response to a Companion Letter issued by CMS with the approval of SPA 19-0005
Approval Date:
Effective Date:
Topics:
  • Health Homes
  • Dental
  • Financing & Reimbursement
Links:
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Transmittal Number: HI-21-0003
State: Hawaii
Summary: Effective January 15, 2021, this amendment removes limits on smoking cessation counseling and pharmacotherapy services. 
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: MS-20-0013
State: Mississippi
Summary: Allows the Division of Medicaid to add coverage of licensed pharmacists under the Other Licensed Practitioners (OLP) for vaccine administration.
Approval Date:
Effective Date:
Topics:
  • Vaccine
Links:
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Transmittal Number: MS-20-0009
State: Mississippi
Summary: This amendment proposes to allow the Division of Medicaid (DOM) to add language to include the cost avoidance of prenatal claims in compliance with the Bipartisan Budget Act of 2018, to update the language describing data exchanges with other agencies, add the process for providers to request an override of the third party liability edit and update the code reference to ICD-10-CM, effective October 1, 2020.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: MS-20-0021
State: Mississippi
Summary: Updates the out-of-state transplant rates as published in the Milliman U.S. Organ and Tissue Transplant Cost Estimates and Discussion
Approval Date:
Effective Date:
Topics:
  • Cost Sharing
  • Program Administration
Links:
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