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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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Transmittal Number: OR-23-0004
State: Oregon
Summary: This amendment is submitted to add two additional provider types to the Other Licensed Provider section of the State Plan.
Approval Date:
Effective Date:
Topics:
  • Other Licensed Practitioners
Links:
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Transmittal Number: WA-22-0032
State: Washington
Summary: This amendment updates the requirements in the Medicaid State Plan for licensed mental health professionals who provide outpatient mental health services to clients eighteen years of age and younger.
Approval Date:
Effective Date:
Topics:
  • Other Licensed Practitioners
Links:
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Transmittal Number: NY-22-0077
State: New York
Summary: Proposes to add Licensed Psychologist to the provider qualification under Other Licensed Practitioners (OLP) by agencies designated under the Child and Family Treatment and Support Services (CFTSS) designation process.
Approval Date:
Effective Date:
Topics:
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OR-22-0018
State: Oregon
Summary: This amendment is to add two additional provider types, Licensed Dietician, and Licensed Genetic Counselor, to the Other Licensed Practitioner section of the State Plan.
Approval Date:
Effective Date:
Topics:
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VT-22-0013
State: Vermont
Summary: This amendment proposes to remove the service limitations for medical nutrition therapy.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NY-22-0045
State: New York
Summary: Proposes to reimburse licensed mental health counselors and licensed marriage and family therapists to bill Medicaid directly for services provided within their scope of practice.
Approval Date:
Effective Date:
Topics:
  • Other Licensed Practitioners
Links:
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Transmittal Number: PA-21-0023
State: Pennsylvania
Summary: Proposes to add licensed pharmacist services to the Other Licensed Practitioner (OLP) benefit.
Approval Date:
Effective Date:
Topics:
  • Other Licensed Practitioners
Links:
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Transmittal Number: UT-21-0015
State: Utah
Summary: This SPA added pharmacists under other licensed practitioners since the state's scope of practice was expanded to allow pharmacist to prescribe certain drugs of devices with their scope of training and experience.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
Links:
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Transmittal Number: NJ-21-0011
State: New Jersey
Summary: Adds coverage for services provided by licensed midwives under the Other Licensed Practitioners' Services benefit.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
Links:
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Transmittal Number: CT-20-0020
State: Connecticut
Summary: Increased the rate per box of 100 non-sterile gloves to $8.00 per box and reduced the quantities to 3 boxes per month, which may be exceeded with prior authorization based on medical necessity. 
Approval Date:
Effective Date:
Topics:
  • Prior Authorization
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT