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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 61 to 70 of 542 results
Transmittal Number: CO-23-0001
State: Colorado
Summary: This amendment add the populations served by the following 1915(c) HCBS waivers as target groups for Targeted

Case Management: Brain Injury (BI), Children's Home and Community Based Services (CHCBS),Children with Life Limiting Illness (CLLI) Complementary and Integrative Health (CIH), Community Mental Health Supports (CMHS), and Elderly, Blind, and Disabled (EBD).
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: CO-23-0006
State: Colorado
Summary: This amendment removes Prior Authorization Request requirements for Home Health Services.  Additionally, the SPA allows practitioners to order and re-order that the patient is eligible for Medicaid Home Health Services.
Approval Date:
Effective Date:
Topics:
  • Health Homes
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CO-23-0007
State: Colorado
Summary: This amendment allows the 240 service unit limit per client for targeted case management services to be exceeded if medically necessary.
Approval Date:
Effective Date:
Topics:
  • Targeted Case Management
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CO-22-0017
State: Colorado
Summary: Effective for services on or after July 1, 2022, this amendment implements supplemental payments to nursing facilities based on discharges and staff wages.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CO-22-0039-A
State: Colorado
Summary: This Amendment sets the coverage limits for long term and acute home health.
Approval Date:
Effective Date:
Topics:
  • Home Health
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CO-23-0012
State: Colorado
Summary: This Amendment updates the State Governor’s Designation Letter for who can sign state plan submissions for Colorado.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: CO-22-0041
State: Colorado
Summary: Effective for services on or after October 1, 2022, this amendment adds clarifying language specific to Disproportionate Share Hospital (DSH) payments as well as updates the hospital quality incentive payments available for qualifying providers.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: CO-22-0009
State: Colorado
Summary: This SPA provides Colorado with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: CO-23-0011
State: Colorado
Summary: This SPA provides coverage for routine patient costs in qualifying clinical trials.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Reimbursement
Links:
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Transmittal Number: CO-21-0014
State: Colorado
Summary: This plan amendment updates the physician services alternative payment model (APM) by changing the time-frame for eligible payments that qualify primary care medical providers (PCMP) for the APM, thereby, making the APM code set

timeline prospective and ongoing rather than tied to specific past dates, and pushing the 2021 APM rate adjustments

back from July 1, 2021 to October 1, 2021.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT