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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 11 to 20 of 36 results
Transmittal Number: PA-23-0018
State: Pennsylvania
Summary: Adds language specifically stating that for beneficiaries under 21 years of age, there are no limits for medically necessary home health nursing services, medically necessary home health aide services, medically necessary home health physical therapy, occupational therapy, speech pathology and audiology services.
Approval Date:
Effective Date:
Topics:
  • Home Health
Links:
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Transmittal Number: NC-23-0050
State: North Carolina
Summary: This amendment proposes to alleviate the effects of the nursing shortage on eligible Private Duty Nursing beneficiaries. The near relative or legally responsible person must have a valid and current nursing license and must operate within their scope of practice to deliver the skilled nursing service.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Home Health
Links:
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Transmittal Number: ME-23-0020
State: Maine
Summary: This amendment proposes to continue provisions previously approved through disaster relief SPAs.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
  • Home Health
  • Other Licensed Practitioners
  • Medical Supplies & Devices
Links:
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Transmittal Number: MA-23-0009
State: Massachusetts
Summary: This amendment is to update the Standard Alternative Benefit Plan (ABP) to add and update certain behavioral health services.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
  • Home Health
  • Prior Authorization
Links:
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Transmittal Number: MA-23-0049
State: Massachusetts
Summary: This amendment is to update the Standard Alternative Benefit Plan (ABP) to update the description of Home Health Part-Time Nursing.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
  • Home Health
  • Prior Authorization
Links:
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Transmittal Number: OH-23-0041
State: Ohio
Summary: Pursuant to state legislation that rescinds Medicaid coverage and payment provisions for outpatient health facilities (OHF), this SPA proposes to remove the obsolete Attachment 3.1-A and 4.19-B pages from the Medicaid State Plan.
Approval Date:
Effective Date:
Topics:
  • Clinic
Links:
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Transmittal Number: NC-23-0046
State: North Carolina
Summary: This amendment proposes to increase the limitations on Outpatient Therapy Services for adults (excluding EPDST eligibles).
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Home Health
  • Other Licensed Practitioners
  • Reimbursement
Links:
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Transmittal Number: NH-23-0036
State: New Hampshire
Summary: This amendment updates the coverage and payment methodologies for substance use disorder clinic services.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
  • Clinic
  • Preventative Services
Links:
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Transmittal Number: MA-23-0008
State: Massachusetts
Summary: This amendment updates the coverage and payment methodologies for substance use disorder clinic services.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
  • Clinic
  • Drugs and Related Services
Links:
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Transmittal Number: VT-23-0039
State: Vermont
Summary: This amendment specifies that select incontinence supplies must be supplied by the statewide contracted vendor unless prior authorized.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Home Health
  • Other Licensed Practitioners
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT