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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 21 - 30 of 15693

Kansas

This plan amendment will reimburse pharmacists for Medication Therapy Management (MTM) intervention services.

Approval Date: April 29, 2025
Effective Date: January 1, 2025

Nebraska

This amendment implements a new prenatal plus program for eligible Medicaid and Children's Health Insurance Plan (CHIP) mothers determined by a health care provider to be at risk of having negative maternal or infant health outcomes.

Approval Date: April 29, 2025
Effective Date: January 1, 2025
Topics: Coverage and Reimbursement

Montana

This state plan amends the fee schedules for services listed on the Introduction Pages.

Approval Date: April 29, 2025
Effective Date: January 1, 2025

North Dakota

Clarifies language for existing benefits, specifically as they relate to those under the age of 21. The amendment will align the Alternative Benefits Plan (ABP) with the changes to traditional Medicaid.

Approval Date: April 28, 2025
Effective Date: July 1, 2024
Topics: Alternative Benefit Plan Coverage

Michigan

This amendment proposed a resource disregard in order to increase the effective resource standards for all Medicaid eligibility groups subject to a resource test.

Approval Date: April 25, 2025
Effective Date: February 1, 2025
Topics: Coverage Eligibility Medicaid and CHIP Program (MACPro)

Idaho

This Amendment updates state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set as outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: April 25, 2025
Effective Date: December 1, 2024
Topics: Medicaid and CHIP Program (MACPro) Program Administration

Maryland

This amendment is proposing the following changes to the 1915(i) program: Increase the timeframe that a face-to-face psychosocial assessment must be completed or updated, expand participant eligibility, update the frequency for POC reviews and Child and Family Team meetings, and remove the separate reimbursement for telephonic peer support services and clarify that Family Peer Support Services can be provided in person and via AV and audio-only telehealth, and add coverage of Youth Peer Support Services.

Approval Date: April 25, 2025
Effective Date: April 1, 2025
Topics: Coverage and Reimbursement Eligibility Home and community based services

New Hampshire

This amendment is to increase its medically needy income level (MNIL).

Approval Date: April 25, 2025
Effective Date: January 1, 2025
Topics: Eligibility Medicaid and CHIP Program (MACPro)

Wisconsin

This amendment modified the maximum amount allowed for the maintenance of a home of institutionalized beneficiaries to reflect the Social Security Cost-of-Living Adjustment (COLA).

Approval Date: April 25, 2025
Effective Date: January 1, 2025

Wisconsin

The state memorialized the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under Wisconsin's State Plan.

Approval Date: April 25, 2025
Effective Date: January 1, 2025