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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 1221 to 1230 of 2111 results
Transmittal Number: CO-23-0002
State: Colorado
Summary: Effective for services on or after January 1, 2023, this amendment authorizes payment for take home Naloxone dispensed by a hospital upon discharge to members deemed at risk of opioid related overdoses. Naloxone is exlcuded from the Diagnostic Related Group (DRG) relative weight calculation and will be paid according to the physician administered drugs payment methodology under the Attachment 4.19-B authority.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: CO-22-0038
State: Colorado
Summary: This plan amendment adds a Chronic Condition Episode-Based Incentive payment to Alternative Payment Methodology (APM) 1 and APM 2.
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Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: OK-23-0020
State: Oklahoma
Summary: 23-0020 which proposes an enhanced payment for intermediate care facilities for individuals with intellectual disabilities that provide vocational services or day program services or both.
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Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CA-23-0003
State: California
Summary: This SPA updates the reimbursement methodology for Durable Medical Equipment.
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Topics:
  • Reimbursement
Links:
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Transmittal Number: CT-23-0010
State: Connecticut
Summary: This plan adds a new reimbursement methodology for continuous glucose monitors (CGMs) when provided by a pharmacy.
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Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-23-0001
State: Maine
Summary: This SPA updates the reimbursement methodology for durable medical equipment (DME) and medical supplies.
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Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: CT-23-0008
State: Connecticut
Summary: This plan increases the rate for self-directed Personal Care Attendant (PCA) services within the Community First Choice benefit.
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Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: UT-23-0009
State: Utah
Summary: The purpose of this SPA is to update pricing for medical supplies and durable medical equipment (DME).
Approval Date:
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Topics:
  • Reimbursement
Links:
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Transmittal Number: MN-23-0011
State: Minnesota
Summary: Coverage and reimbursement of COVID-19 vaccines and vaccine administration, coverage and reimbursement of COVID-19 testing, coverage and reimbursement of services for the treatment and prevention of COVID-19, including conditions that may seriously complicate the treatment of COVID-19.
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Topics:
  • Reimbursement
Links:
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Transmittal Number: OH-23-0011
State: Ohio
Summary: This SPA implements coverage of the new mandatory benefits of COVID 19 Vaccines and Administration of the Vaccines, Diagnostic and Screening Tests, and Treatment, Specialized Equipment and Therapies, and Preventive Therapies in accordance with the requirements of Section 9811 of the American Rescue Plan (ARP) Act.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT