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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 131 to 140 of 551 results
Transmittal Number: AL-20-0001
State: Alabama
Summary: Proposes to change the default pharmacy ingredient cost reimbursement methodology 
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Active Pharmaceutical Ingredient & Excipient Removal
  • Financing & Reimbursement
Links:
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Transmittal Number: IN-19-0019
State: Indiana
Summary: This SPA make Changes to Pharmacy DUR language to adhere to SUPPORT Act requirements
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Current State Plan
  • Prescription Drugs
Links:
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Transmittal Number: SC-19-0006
State: South Carolina
Summary: Incorporates the language mandated in 1902 (a)(85) and Section 1004 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MI-19-0012
State: Michigan
Summary: Changes to the state's Pharmacy DUR language in compliance with the SUPPORT Act.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Current State Plan
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MA-19-0032
State: Massachusetts
Summary: Allows the state to comply with the Medicaid Drug Utilization Review (DUR)

provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes

Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: GA-20-0001
State: Georgia
Summary: Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT)
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Current State Plan
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MI-19-0013
State: Michigan
Summary: Clarifies coverage of certain Active Pharmaceutical Ingredients (APIs) and Excipients when billed as part of a compounded drug claim
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Benefits
  • Eligibility
Links:
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Transmittal Number: WA-19-0014
State: Washington
Summary: Affirms state compliance with sections 1902(a)(85), 1902(a)(83)(oo), and 1927(g) of the Social Security Act; updates Drug Utilization Review program information; affirms state fraud and abuse processes related to opioids; affirms MCO requirements to participate in SUPPORT Act-mandated actions; and updates language to align with language in the Social Security Act and CFR
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: WI-19-0013
State: Wisconsin
Summary: Updates WI's drug utilization program provisions to include requirements established in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: HI-19-0006
State: Hawaii
Summary: Comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Current State Plan
  • Prescription Drugs
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT