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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 1 to 10 of 172 results
Transmittal Number: OK-24-0025
State: Oklahoma
Summary: This amendment extends the exception for the Recovery Audit Contractor (RAC) Program for an additional two-year period.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: OK-21-0041
State: Oklahoma
Summary: Updates and clarifies the frequency and method for re-basing Certified Community Behavioral Health (CCBH) Prospective Payment System (PPS) rates based on cost reports.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: OK-22-0024
State: Oklahoma
Summary: This amendment to amend the State Plan to include an exemption from the recovery audit contract (RAC) requirement.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: OK-21-0043
State: Oklahoma
Summary: Provides assurances regarding the state's compliance with federal medical transportation requirements found under the Consolidated Appropriations Act, 2021.
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Benefits
Links:
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Transmittal Number: OK-21-0047
State: Oklahoma
Summary: Revises the language describing the methodology used to calculate the capitation rate payment for PACE organizations. The SPA will remove the Medicare Economic Index ( MEI) adjustment from the rate methodology, as the PACE capitation rate is based on the amount that would otherwise be paid (AWOP) which is reviewed annually and adjusted as needed, without regard to the MEI.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
Links:
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Transmittal Number: OK-221-0042
State: Oklahoma
Summary: establishes the reimbursement rate for intensive residential substance use disorder (SUD) treatment for adolescents (clinically managed medium intensity residential services for adolescents, intensive).
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Benefits
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Transmittal Number: OK-21-0027
State: Oklahoma
Summary: Oklahoma's Annual Rebasing of Rates for regular nursing facilities 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: OK-21-0022-C
State: Oklahoma
Summary: The primary purpose of this SPA is to remove health home program services which will be covered and reimbursed under the state plans Certified Community Behavioral Health (CCBH) services.
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Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: OK-21-0031
State: Oklahoma
Summary: Alternative Benefit Plan (ABP) amendment to establish the existing Primary Care Case Management (PCCM) service delivery system for expansion adults
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Benefits
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Transmittal Number: OK-21-0025
State: Oklahoma
Summary: This SPA was submitted to annotate that the state requires providers to bill liable third parties when services covered under the Plan are furnished to a member on whose behalf child support enforcement is being carried out
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
    SHARE THIS MEDICAID STATE PLAN AMENDMENT