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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 516 results
Transmittal Number: CO-20-0025
State: Colorado
Summary: provides for a two percent increase to the statewide average Medicaid Management Information Systems (MMIS) reimbursement rate.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: CO-20-0035
State: Colorado
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 establish a COVID-19 interim payment methodology for primary care medical providers (PCMP) who provide integrated services.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Financing & Reimbursement
Links:
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Transmittal Number: CO-20-0018
State: Colorado
Summary: Updates and corrects the assurances selected related to utilization review to indicate that the Department undertakes utilization review requirements through a contract with a utilization and Quality Improvement Organization (QIO) or QIO-Like Entity.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: CO-20-0020
State: Colorado
Summary: updates drug reimbursement for outpatient hospital services
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: CO-20-0017
State: Colorado
Summary: Updates the methodology for existing, supplemental payments for nursing facilities (NFs)
Approval Date:
Effective Date:
Topics:
  • Allocation Methodologies
  • Program Administration
Links:
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Transmittal Number: CO-20-0019
State: Colorado
Summary: revises telemedicine to allow audio and data communications in addition

to audio-video communications
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: CO-20-0009
State: Colorado
Summary: Changes from paying licensed pharmacists individually for Medication Therapy Counseling to contracting with an entity to run the program, and updates program requirements and restrictions.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: CO-20-0013
State: Colorado
Summary: Proposes to update the pharmaceutical rate methodology by including National Average Drug Acquisition (NADAC) and Maximum Allowable Cost (MAC) into the lesser of logic methodology. 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: CO-20-0004
State: Colorado
Summary: Decreases clinical diagnostic laboratory rates on a per-test basis to align with Medicare rates in accordance with the Social Security Act Section 1903(i)(7)
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: CO-20-0012
State: Colorado
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide flexibilities in the areas of home health, transportation, telemedicine, inpatient hospital services, and pharmacy benefits.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Prescription Drugs
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT