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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.

Results

Displaying 1 - 10 of 15893

District of Columbia

This amendment proposes to include coverage of FDA-approved over-the-counter COVID-19 tests under the State Plan. The initial SPA submission has been revised to incorporate the required language in the Preventive Services benefit instead of the Pharmacy benefit.

Approval Date: August 28, 2025
Effective Date: October 1, 2024
Topics: Coverage Preventive Services Program Administration

Louisiana

The SPA makes provisions governing the Medicaid Purchase Plan to increase the income limit and countable resources and to adjust the premium structure accordingly.

Approval Date: August 28, 2025
Effective Date: April 1, 2025

New Jersey

This amendment revises the COVID-19 Vaccine administration rates from 100% to 50% of current Medicare rates

Approval Date: August 28, 2025
Effective Date: October 1, 2024

Utah

This amendment makes changes to tribal consultation policies.

Approval Date: August 28, 2025
Effective Date: July 1, 2025

Colorado

This plan amendment proposes to to increase Hospice provider rates and update the fee-schedule date effective October 11, 2024.

Approval Date: August 28, 2025
Effective Date: October 11, 2024

Wisconsin

This plan amendment adds reimbursement for Treat-in-Place/No Transport services.

Approval Date: August 28, 2025
Effective Date: January 1, 2025

New Hampshire

This amendment proposes to amend the Title XIX State Plan in response to the Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System final rule issued by CMS on November 27, 2024.

Approval Date: August 26, 2025
Effective Date: April 1, 2025
Topics: Clinic Tribal/Indian Health Services

Nebraska

This amendment added pre-natal plus program to Alternative Benefit Plan (ABP).

Approval Date: August 26, 2025
Effective Date: January 1, 2025

Maine

This amendment proposes to extend Maine’s Recovery Audit Contractor (RAC) program exception from June 1, 2025, through May 31, 2027.

Approval Date: August 22, 2025
Effective Date: June 1, 2025

Kentucky

This plan amendment is amending its State Plan to implement a quality program funded by the provider assessment and clarifying how payment for ancillary services is part of the per diem rate.

Approval Date: August 21, 2025
Effective Date: July 1, 2025