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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 51 - 60 of 15695

North Dakota

This amendment updates the recipient and provider qualifications for Target Case Management (TCM) for individuals with a behavioral health condition.

Approval Date: April 14, 2025
Effective Date: January 1, 2025
Topics: Coverage Targeted Case Management

Maryland

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

Montana

This Medicaid State Plan is updated to attest that Montana complies with all requirements for reporting on the Child and Adult Core Sets and will report annually on the measures in the Child Core Set and the behavioral health measures in the Adult Core Set.

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

District of Columbia

This plan amendment is to update the fee schedule reimbursement rates for home health services.

Approval Date: April 10, 2025
Effective Date: January 1, 2025

Nevada

This SPA updates the licensed practitioner benefit to allow school-based providers with Department of Education endorsement and a current licensure to include school counselors, school social workers, and school psychologists to provide services to school-aged Medicaid recipients.

Approval Date: April 9, 2025
Effective Date: January 1, 2025

North Dakota

This plan amendment amends the State Plan to reimburse hospital leave days for Psychiatric Residential Treatment Facilities.

Approval Date: April 9, 2025
Effective Date: January 1, 2025

North Dakota

This plan amendment updates the inflation factor for Psychiatric Residential Treatment Facilities (PRTF) daily rates.

Approval Date: April 9, 2025
Effective Date: January 1, 2025

Idaho

This plan amendment updates fee schedules language for service rehabilitation benefits section to comply with federal requirements and updates outdated language.

Approval Date: April 8, 2025
Effective Date: July 1, 2024

Minnesota

This amendment updates rates for mental health services according to the resource-based relative value scale (RBRVS).

Approval Date: April 8, 2025
Effective Date: January 1, 2025

Michigan

This plan amendment increases the amount of its GME Innovations agreement with Pine Rest Christian Mental Health Services.

Approval Date: April 8, 2025
Effective Date: January 1, 2025