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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 1 - 10 of 15975

New Mexico

This plan amendment updates the rates for noninstitutional outpatient services, maternal and child health services, primary care, behavioral health services, and other services and adds a supplemental payment for institutional services for intermediate care facilities.

Approval Date: September 18, 2025
Effective Date: January 1, 2025

Utah

Through June 2025, this amendment extends funding for ARPA Spending Plan Supplemental Payments and limits the final quarter’s supplemental payment to no less than 0 percent and no greater than 5 percent, effective June 2, 2025

Approval Date: September 18, 2025
Effective Date: June 2, 2025

Massachusetts

The amendment is to update the Care Plus Alternative Benefit Plan (ABP) to add licensed mental health counselors and licensed marriage and family therapists to the other practitioners’ service provider type.

Approval Date: September 18, 2025
Effective Date: April 1, 2025
Topics: Benefits Coverage Other Licensed Practitioners

Ohio

This amendment is to provide for mandatory coverage in accordance with section 1902(a)(84)(D) of the Social Security Act (the Act) for eligible juveniles that are incarcerated in a public institution post-adjudication of charges.

Approval Date: September 18, 2025
Effective Date: January 1, 2025
Topics: Coverage Eligibility Targeted Case Management

Texas

The proposed amendment updates the Ambulatory Surgical Center reimbursement fee schedule.

Approval Date: September 18, 2025
Effective Date: June 7, 2025

Arizona

This plan amendment adjusts the Inpatient Hospital APR-DRG newborn policy adjustor to account for increases in the newborn screening fee.

Approval Date: September 17, 2025
Effective Date: June 1, 2025

Massachusetts

The amendment is to update the Standard Alternative Benefit Plan (ABP) to add licensed mental health counselors and licensed marriage and family therapists to the other practitioners’ service provider type.

Approval Date: September 17, 2025
Effective Date: April 1, 2025
Topics: Benefits Coverage Other Licensed Practitioners

Massachusetts

This amendment proposes to add licensed mental health counselor and licensed marriage and family therapist to the other practitioners’ service provider types.

Approval Date: September 16, 2025
Effective Date: April 1, 2025
Topics: Coverage Other Licensed Practitioners

Michigan

This amendment is to provide for mandatory coverage in accordance with section 1902(a)(84)(D) of the Social Security Act (the Act) for eligible juveniles who are incarcerated in a public institution post-adjudication of charges.

Approval Date: September 15, 2025
Effective Date: January 1, 2025
Topics: Coverage Eligibility Reimbursement Targeted Case Management

North Dakota

This amendment increases the personal needs allowance.

Approval Date: September 15, 2025
Effective Date: July 1, 2025