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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 1 to 10 of 14 results
Transmittal Number: OR-25-0003
State: Oregon
Summary: This amendment revises Oregon’s Tribal Consultation Policy.
Approval Date:
Effective Date:
Topics:
  • Tribal/Indian Health Services
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: WA-24-0005
State: Washington
Summary: This amendment will add one (1) encounter eligible visit per IHS-eligible Medicaid beneficiary per day to the currently allowed five (5) encounters per day.
Approval Date:
Effective Date:
Topics:
  • Tribal/Indian Health Services
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MT-24-0002
State: Montana
Summary: Move authority for the Tribal Health Improvement Program (T-HIP) from a 1915(b) waiver to a 1932(a) SPA, while further aligning the program design with primary care case management entity requirements found in 42 CFR § 438.2.
Approval Date:
Effective Date:
Topics:
  • Managed Care
  • Tribal/Indian Health Services
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-23-0009
State: New Mexico
Summary: This SPA amends the language provisions for coverage of select nonprescription drugs.
Approval Date:
Effective Date:
Topics:
  • Non-prescription Drugs
  • Over-the-Counter Drugs
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: DC-23-0016
State: District of Columbia
Summary: This amendment allows the District to update the state’s excluded drug listing; to provide coverage for select agents for the treatment of infertility; to enter in Outcome-based arrangements with manufacturers; and to increase flexibility to improve access to prescription and over-the-counter drugs.
Approval Date:
Effective Date:
Topics:
  • Value Based Purchasing
  • Prescribed Drugs
  • Covered Outpatient Drug
  • Over-the-Counter Drugs
  • Non-prescription Drugs
  • Fertility Drugs
  • Excluded Drug Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NC-23-0032
State: North Carolina
Summary: This amendment is to include the new adult group in Eastern Band of Cherokee Indians (EBCI) Tribal Option primary care case management entity (PCCMe) program eligibility.
Approval Date:
Effective Date:
Topics:
  • Managed Care
  • Medicaid Expansion
  • Tribal/Indian Health Services
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-23-0015
State: Maryland
Summary: Modifies the language that describes the rate categories for the Program of All-Inclusive Care for the Elderly (PACE) by removing the QMB rates in the rate-setting methodology. This change does not fundamentally change the formula for rate calculation.
Approval Date:
Effective Date:
Topics:
  • Quality of Care
  • Benefits
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VA-23-0002
State: Virginia
Summary: To update sections of the state plan that pertain to the Program of All-Inclusive Care for the Elderly.
Approval Date:
Effective Date:
Topics:
  • Quality of Care
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MS-22-0007
State: Mississippi
Summary: This SPA allows the Mississippi Medicaid program to update and identify the Mississippi Band of Choctaw Indians (MBCI) designees.
Approval Date:
Effective Date:
Topics:
  • Tribal/Indian Health Services
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VA-22-0007
State: Virginia
Summary: Improves the quality and outcomes of care for the nursing facility Value-Based Purchasing program.
Approval Date:
Effective Date:
Topics:
  • Quality of Care
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT