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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.

Results

Displaying 121 - 130 of 15696

District of Columbia

This amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: March 14, 2025
Effective Date: December 31, 2024
Topics: Medicaid and CHIP Program (MACPro) Program Administration

Delaware

To modify the personal needs allowance amount for individuals residing in long-term care facilities.

Approval Date: March 14, 2025
Effective Date: January 1, 2025

Maryland

To implement Express Lane Eligibility (ELE) to streamline and expedite renewal of eligible individuals in the Maryland Medicaid
Assistance Program and Maryland Children’s Health Program (MCHP).

Approval Date: March 14, 2025
Effective Date: July 1, 2025

Connecticut

This amendment is to reduce the income standard for the parents and caretaker relatives eligibility group from 155 percent of the federal poverty level to 133 percent of the federal poverty level.

Approval Date: March 14, 2025
Effective Date: October 1, 2024
Topics: Eligibility Medicaid and CHIP Program (MACPro)

Maine

This amendment is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: March 14, 2025
Effective Date: October 1, 2024
Topics: Medicaid and CHIP Program (MACPro) Program Administration

Vermont

This amendment proposed new disregards for Medicare Savings Program eligibility groups.

Approval Date: March 14, 2025
Effective Date: April 1, 2024
Topics: Coverage Eligibility Medicaid and CHIP Program (MACPro)

Alaska

This SPA allows Alaska to enter into value/outcome-based contracts with pharmaceutical manufacturers on a voluntary basis.

Approval Date: March 13, 2025
Effective Date: January 1, 2025
Topics: Value Based Purchasing

American Samoa

This amendment adds on and off-island outpatient dialysis services to within dialysis clinics and Free standing ESRD clinics. Additionally, this amendment makes technical edits to dental services in the state plan.

Approval Date: March 13, 2025
Effective Date: October 1, 2024
Topics: Coverage and Reimbursement

North Carolina

This amendment proposes to remove the medically monitored detoxification services from rehabilitative services benefit. This level of care will be provided in inpatient settings, aligning with the ASAM levels of care outlined in the state's 1115 SUD demonstration.

Approval Date: March 12, 2025
Effective Date: January 1, 2025
Topics: Coverage Preventive Services Reimbursement

Massachusetts

This amendment adds doula service coverage for adoptive parents of infants.

Approval Date: March 12, 2025
Effective Date: November 8, 2024
Topics: Coverage Preventative Services