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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 21 to 30 of 80 results
Transmittal Number: WA-24-0007
State: Washington
Summary: This amendment will add Community Health Aide Providers (CHAPs) to the other licensed practitioner's benefit in the state plan.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: UT-24-0002
State: Utah
Summary: This SPA proposes to clarify the reimbursement for certain provider administered drugs.
Approval Date:
Effective Date:
Topics:
  • Covered Outpatient Drug
  • Physician Administered Drugs
  • Prescribed Drugs
  • Prescription Drugs
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: WA-24-0038
State: Washington
Summary: This amendment will remove a typographical error in Attachment 3.1-B page 21a.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: WA-24-0012
State: Washington
Summary: This amendment will add Substance Use Disorder Professionals, Licensed Independent Clinical Social Worker Associates, Licensed Advance Social Worker Associates, Licensed Marriage & Family Therapist Associates, & Licensed Mental Health Counselor Associates as Other Licensed Practitioners in the State Plan.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VA-24-0005
State: Virginia
Summary: Updates the state plan language referenced in the section, Other Licensed Providers. The SPA removes the reference to ophthalmologists, as these are physicians and are covered under the Physician Services section of the state plan, clarifies that optometrists and opticians are licensed providers and lists each type of other licensed provider that can enroll with the Virginia Department of Medical Assistance Services.
Approval Date:
Effective Date:
Topics:
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VT-24-0003
State: Vermont
Summary: This SPA is to update the 2024 Base Benchmark.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
  • Inpatient
  • Other Licensed Practitioners
  • Home Health
  • Prior Authorization
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-24-0007
State: Maryland
Summary: This amendment proposes to allow Medicaid-enrolled pharmacists to bill Maryland Medicaid for professional services rendered within their lawful scope of practice.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
  • Drugs and Related Services
  • Preventative Services
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NC-24-0012
State: North Carolina
Summary: This SPA removes language that set Physician Administered Drug Program (PADP) fee schedule rates as of January 1, 2015 and allows for rates to be updated.
Approval Date:
Effective Date:
Topics:
  • Physician Administered Drugs
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NY-23-0094
State: New York
Summary: To authorize payment for Evidence-Based Practices (EBPs) provided to children/youth referred and eligible for Children and Family Treatment and Support Services (CFTSS) by agencies designated in Other Licensed Practitioner (OLP) and/or Community Psychiatric Supports and Treatment (CPST) by the New York State designation process that have completed the EBP training and certification process.
Approval Date:
Effective Date:
Topics:
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SC-23-0015
State: South Carolina
Summary: This amendment proposes to add Multisystemic Therapy (MST) to the South Carolina Rehabilitative Services benefit.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Benefits
  • Reimbursement
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT