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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 111 to 120 of 382 results
Transmittal Number: ME-19-0004
State: Maine
Summary: Updates fee schedule rates for Speech and Hearing services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-20-0002
State: Maine
Summary: Updates fee schedule rates for Ambulance services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: ME-22-0014
State: Maine
Summary: Updates the reimbursement methodology for ambulance services and neonatal transport services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-21-0022
State: Maine
Summary: Adding CPT code 96125 to OT benefit effective 11/1/2021
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: ME-17-0011
State: Maine
Summary: updates fee schedule rates for Physical Therapy and Occupational Therapy services
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: ME-22-0025
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 revise the previously approved date for payment of retention bonuses to direct support workers pursuant to the American Rescue Plan Act (ARP) of 2021, Section 9817 (Pub. L. 117-2). Payment by agencies to staff must occur between July 1, 2021 and December 31, 2022.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: ME-22-0013
State: Maine
Summary: adds a value-based purchasing (VBP) supplemental sub-pool that distributes $600,000 annually to eligible hospitals based on performance on one or more predetermined quality measures.
Approval Date:
Effective Date:
Topics:
  • Value Based Purchasing
Links:
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Transmittal Number: ME-22-0024
State: Maine
Summary: This plan amendment sets the rate for optometry, chiropractic, and podiatry services supplies at the lower of provider charges or 72.4% of the current Maine Medicare rate and by fee schedule for such se1vices not covered by Medicare.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0016
State: Maine
Summary: This SPA provides Maine 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: PR-22-0001
State: Puerto Rico
Summary: This SPA update Third Party Liability (TPL) requirements as authorized under the Bipartisan Budget Act (BBA) of 2018 (Pub. L. 115- 123) and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019 (Pub. L. 116-16).
Approval Date:
Effective Date:
Topics:
  • Third Party Liability
Links:
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