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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 481 to 490 of 1180 results
Transmittal Number: MI-19-0013
State: Michigan
Summary: Clarifies coverage of certain Active Pharmaceutical Ingredients (APIs) and Excipients when billed as part of a compounded drug claim
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Benefits
  • Eligibility
Links:
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Transmittal Number: ME-19-0024
State: Maine
Summary: Proposes reimbursement to hospitals other than critical access hospitals for each day after the tenth (10th) day that an eligible individual is in the care of the hospital while awaiting placement in a nursing facility
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Financing & Reimbursement
Links:
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Transmittal Number: ME-19-0001
State: Maine
Summary: This eligibility SPA increases the eligibility thresholds for the state’s Medicare Savings Program eligibility groups effective 2/1/20. This SPA also updates the levels for the Optional State Supplement Beneficiaries group effective 1/1/20
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: OK-20-0011
State: Oklahoma
Summary: To include pancreas and intestinal transplants as covered organ and tissue transplant procedures.  It also updated transplant standards to include donor search and procurement services and to ensure that the methods used for organ acquisition are consistent with the Medicare program
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Program Administration
  • Current State Plan
Links:
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Transmittal Number: WI-19-0017
State: Wisconsin
Summary: Modifies Disproportionate Share Hospital (DSH) Payments. Specifically, this amendment modifies payments to hospitals that serve a disproportionate share of low-income patients and meet eligibility requirements
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Financing & Reimbursement
Links:
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Transmittal Number: OH-20-0002
State: Ohio
Summary: Provider Enrollment & Screening
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Eligibility
  • Program Administration
Links:
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Transmittal Number: LA-19-0027
State: Louisiana
Summary: Proposes to establish qualifying criteria and a for disproportionate share hospital (DSH) payment methodology for West Jefferson Hospital, a major medical center located in southeastern area of Louisiana
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: VT-19-0007
State: Vermont
Summary: Revises the prior authorization requirements for special eyewear lenses
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Benefits
Links:
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Transmittal Number: ID-19-0022
State: Idaho
Summary: Clarifies populations eligible to receive all medically necessary services, as provided under the Idaho State Plan
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: LA-18-0027
State: Louisiana
Summary: Update the electronic Medicaid application that was developed as part of the state’s new eligibility and enrollment system
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Current State Plan
  • Data & Systems
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT