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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 98 results
Transmittal Number: KS-23-0015
State: Kansas
Summary: This amendment align premium rates for the Working Healthy program with recent changes to the protected income level for Kansas Home- and Community-Based Services waivers, which eliminates premiums for most beneficiaries.
Approval Date:
Effective Date:
Topics:
  • Premiums
  • Cost Sharing
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: WI-23-0011
State: Wisconsin
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend the suspension of premiums for the state's Work Incentives group under section 1902(a)(10)A)(ii)(XIII) of the Act.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Premiums
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VI-22-0002
State: Virgin Islands
Summary: To remove the cash required to pay Part B premiums. VI will pay Part B premiums for all beneficiaries who also qualify for Medicare.
Approval Date:
Effective Date:
Topics:
  • Premiums
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CA-22-0045
State: California
Summary: This amendment is to comply with federal requirements on premium and cost sharing tracking and assessing copays on non-emergency use of services provided in emergency departments. This amendment proposes to eliminate copayments in the Medi-Cal program effective July 1, 2022. 
Approval Date:
Effective Date:
Topics:
  • Premiums
  • Cost Sharing
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CO-22-0031
State: Colorado
Summary: This Amendment increases the cost-sharing imposed for non-emergency use of a hospital’s emergency department from $6 to $8, in accordance with the 2022 Colorado General Assembly Long Bill (House Bill 22-1329).
Approval Date:
Effective Date:
Topics:
  • Premiums
  • Cost Sharing
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OH-22-0033
State: Ohio
Summary: This SPA approves language specifying that the Single Pharmacy Benefit Manager (SPBM) will follow Ohio’s Unified Preferred Drug List.
Approval Date:
Effective Date:
Topics:
  • Prescribed Drugs
  • Covered Outpatient Drug
  • Preferred Drug Lists
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CA-22-0042
State: California
Summary: This SPA will reduce premiums to $0 for the Optional Targeted Low-Income Child (OTLIC) group, which covers eligible individuals with a family income determined to be above 160 percent of the Federal Poverty Level.
Approval Date:
Effective Date:
Topics:
  • Premiums
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MI-20-0006
State: Michigan
Summary: Proposed to establish a single preferred drug list  (PDL) for Michigan Medicaid Pharmacy Coverage
Approval Date:
Effective Date:
Topics:
  • Preferred Drug Lists
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: ID-19-0003
State: Idaho
Summary: Imposes a premium as a condition of eligibility
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Premiums
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: WA-20-0009
State: Washington
Summary: Establishes a new premium for a new eligibility group
Approval Date:
Effective Date:
Topics:
  • Premiums
  • Eligibility
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT