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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 631 - 640 of 15690

New York

This plan amendment provides a seven and a half percent rate increase to nursing homes.

Approval Date: September 24, 2024
Effective Date: April 1, 2024

Minnesota

This plan amendment updates the DSH payments to a hospital that discharged a patient following an extended stay.

Approval Date: September 24, 2024
Effective Date: July 1, 2024

Maine

This amendment proposes to add the requirement for Tier 2 and Tier 3 PCPlus practices to ensure the provision of community based Community Health Worker (CHW) services. It also includes minor methodological and operational updates.

Approval Date: September 24, 2024
Effective Date: April 1, 2024
Topics: Coverage Program Administration Reimbursement

Arizona

This amendment proposes to add coverage for doula services.

Approval Date: September 23, 2024
Effective Date: October 1, 2024
Topics: Coverage and Reimbursement

Texas

This SPA amendment, the state is updating performance measures for provider qualification requirements.

Approval Date: September 23, 2024
Effective Date: July 1, 2024
Topics: Home and community based services

New Mexico

This amendment excludes ABLE accounts from Medicaid Estate Recovery (House Bill 98).

Approval Date: September 20, 2024
Effective Date: July 1, 2024
Topics: Program Administration

Wisconsin

This Amendment totally disregards Medicare Advantage Supplemental Benefits as income and Goals and objectives as assets.

Approval Date: September 20, 2024
Effective Date: March 1, 2024
Topics: Eligibility Medicaid and CHIP Program (MACPro)

Connecticut

This amendment updates HCPCS reimbursement to physician office & outpatient/radiology/surgery, independent radiology, MEDS, lab, adult/children dental services, audiology/speech & language, ambulatory surgical centers, rehab/medical and behavioral health clinics. This SPA also updates reimbursement to physician admin drugs; adult complex skilled nursing services; long-acting reversible contraceptives (LARCs) and adds periodontal SRP services. It also extends rate add-ons for pediatric inpatient psych and the states person centered medical homes (PCMH+) program.

Approval Date: September 20, 2024
Effective Date: January 1, 2024
Topics: Coverage and Reimbursement

Puerto Rico

Increases non-MAGI group resource limits, make adjustments to certain income and resource disregards, and memorialize certain MAGI related elections.

Approval Date: September 20, 2024
Effective Date: May 29, 2024

Puerto Rico

Coverage for various optional eligibility groups.

Approval Date: September 20, 2024
Effective Date: May 29, 2024