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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 91 to 100 of 508 results
Transmittal Number: ME-22-0037
State: Maine
Summary: This SPA authorizes add-on payments for specified sexual and reproductive

health codes provided by qualified providers.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0010
State: Maine
Summary: This amendment is to address the needs of adults and children with significant mental health and co-occurring diagnoses.
Approval Date:
Effective Date:
Topics:
  • Health Homes
Links:
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Transmittal Number: ME-22-0044
State: Maine
Summary: This amendment proposes to comply with Electronic Visit Verification System (EVV) requirements by January 1, 2023, in accordance with Section 12006 of the 21st Century CURES Act.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: ME-22-0034
State: Maine
Summary: This plan amendment authorizes a 4.9% rate increase for Family Planning and Supplies

services that do not have a Medicare rate.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0029
State: Maine
Summary: This plan amendment updates the reimbursement methodology for physician services,

family planning and supplies, nurse-midwife services, and nurse practitioner services to the lower

of provider charges or 72.4% of the current corresponding Medicare rate, updates the fee schedule

for those services not covered by Medicare, and removes outdated provisions related to the

Primary Care Case Management (PCCM) program.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ID-21-0003
State: Idaho
Summary: Effective for services on or July 1,2021, this amendment updates the supplemental payment methodology to hospitals for inpatient and outpatient services. Specifically, these changes will associate supplemental payments with quality of services and participation in the Healthy Connections Value Care (HCVC) program, further linking inpatient and outpatient hospital services to quality and value of patient care.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0031
State: Maine
Summary: This plan amendment authorizes a 4.9% rate increase for Home Health Care services and Medical Social services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0036
State: Maine
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to provide add-on payments for services rendered by family planning agency providers.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: ID-22-0009
State: Idaho
Summary: Renewing Idaho’s Home and Community Base Services (HCBS)1915, Yes Empowerment Services (YES) State Plan Benefit, targeting children with serious emotional disturbances (SED). This benefit will provide respite services for children and youth who have a substantial functional impairment that is measured by and documented through the use of a standardized instrument conducted or supervised by a qualified independent assessor clinician.
Approval Date:
Effective Date:
Topics:
  • Home and community based services
Links:
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Transmittal Number: ME-22-0039
State: Maine
Summary: Effective July 1, 2022, this amendment implements an add-on component to enable nursing facilities to cover labor costs for essential support workers to equal at least 125% of the state minimum wage, plus related taxes and benefits. The amendment also eliminates the requirement for base-year direct and routine aggregate costs per day to be less than the median aggregate direct and routine allowable costs for a facility’s peer group, so that all facilities with MaineCare days constituting more than 80% of total days across all payers will receive a High MaineCare Utilization Payment of $0.60 per diem for each one percentage (1%) of MaineCare days above 80%.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT