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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 27 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:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
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: 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: 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:
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Transmittal Number: WA-23-0027
State: Washington
Summary: This amendment will update SPA language regarding appropriate provider types to reflect current Care Coordination Organizations and will modify language to better align with current program policy, and updates rates for the Health Home program.
Approval Date:
Effective Date:
Topics:
  • Home Health
  • Medicaid and CHIP Program (MACPro)
Links:
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Transmittal Number: VA-23-0012
State: Virginia
Summary: Allows the Virginia Medicaid program to comply with the 21st Century Cures Act requirement to implement an Electronic Visit Verification System for Home Health Care Services.
Approval Date:
Effective Date:
Topics:
  • Home Health
Links:
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Transmittal Number: MT-23-0013
State: Montana
Summary: This SPA makes permanent telehealth flexibilities for home health services and to expand qualified providers to conform with federal regulatory changes.
Approval Date:
Effective Date:
Topics:
  • Home Health
  • Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT