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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 52 results
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: CO-23-0040
State: Colorado
Summary: This SPA updates the service unit limit from 240 to 360 per client for targeted case management-transition coordination, adds eligible individuals that reside in a hospital, adds eligible individuals that are at-risk of institutionalization, and changes the name of the service from Transition Services to Transition Coordination Services.
Approval Date:
Effective Date:
Topics:
  • Targeted Case Management
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MS-23-0025
State: Mississippi
Summary: This amendment proposes to allow the Division of Medicaid to revise rates to an hourly rate and a fifteen-minute add-on rate, remove rate freeze language, and revise service components to align with the Department of Mental Health requirements.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
  • Targeted Case Management
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: LA-23-0040
State: Louisiana
Summary: This SPA is to amend the provisions governing Targeted Case Management (TCM) under the New Opportunities Waiver (NOW), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), and EarlySteps programs in order the clarify language and ensure the requirements for TCM services are accurately reflected throughout the State Plan.
Approval Date:
Effective Date:
Topics:
  • Targeted Case Management
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: DE-23-0007
State: Delaware
Summary: This SPA amends the State Plan to allow the State to enter into value-based contract arrangements with drug manufacturers through supplemental rebate agreements.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Coverage and Reimbursement
  • Preferred Drug Lists
  • Physician Administered Drugs
  • Prescription Drugs
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: DE-23-0003
State: Delaware
Summary: This SPA updates language on the Delaware excluded drug coverage pages to reflect coverage of selective medications by referencing the state’s webpage and policy handbook resources instead of listing specific covered medications. Additionally, the SPA amends the Title XIX Medicaid State Plan regarding physician administered drug reimbursement rates.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Coverage and Reimbursement
  • Preferred Drug Lists
  • Physician Administered Drugs
  • Prescription Drugs
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CA-23-0026
State: California
Summary: This amendment expands the qualified providers for behavioral health providers under the rehabilitative and targeted case management benefits.
Approval Date:
Effective Date:
Topics:
  • Targeted Case Management
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VA-23-0008
State: Virginia
Summary: Revises the state plan to add new targeted case management services for individuals who have severe brain injury.
Approval Date:
Effective Date:
Topics:
  • Targeted Case Management
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: LA-23-0038
State: Louisiana
Summary: This SPA is to amend the provisions governing Targeted Case Management under the New Opportunities Waiver (NOW) and Early and Periodic Screening, Diagnostic and Treatment (EPSDT) programs, in order to allow two quarterly virtual visits that are not the initial visit or the annual plan of care visit.
Approval Date:
Effective Date:
Topics:
  • Targeted Case Management
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VT-23-0007
State: Vermont
Summary: This amendment proposes to add targeted case management coverage for the Sustained Family Support Home Visiting Program using the evidence-based home visiting model, Parents as Teachers (PAT).
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Targeted Case Management
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT