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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 21 - 30 of 15893

Wisconsin

This amendment is adding additional coverage and payment details for delivering school-based services.

Approval Date: August 18, 2025
Effective Date: July 1, 2025

Northern Mariana Islands

This amendment invokes 1902(j) waiver authority to exempt the Commonwealth of the Northern Mariana Islands (CNMI) from the requirements under 1902(a)(84)(D) of the Social Security Act.

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

Wisconsin

The purpose of this SPA is to clarify: (1) delivery of the Child Care Coordination service will occur via the managed care delive1y system and (2) Health Maintenance Organizations provide dental services in specified WI counties.

Approval Date: August 18, 2025
Effective Date: April 1, 2025

Mississippi

This amendment allows the Division of Medicaid (DOM) to update the calculation of the Prescribed Pediatric Extended Care (PPEC) rates to use the 2023 average small nursing facility rates.

Approval Date: August 14, 2025
Effective Date: May 1, 2025

South Dakota

This amendment adds Alternative Benefit Plan (ABP) coverage for doula services.

Approval Date: August 14, 2025
Effective Date: January 1, 2025

Nebraska

This amendment extends the recovery audit contractor for two years.

Approval Date: August 13, 2025
Effective Date: December 1, 2025

Texas

The amendment renews Texas’ 1915(i) State Plan HCBS benefit. The effective date for this renewal is September 1, 2025.

Approval Date: August 13, 2025
Effective Date: September 1, 2025
Topics: Home and community based services

Hawaii

This amendment modifies coverage of dental services to include dental providers who see individuals with intellectual/developmental disabilities (I/DD) and challenging behaviors and to include coverage of non-fluoride agents.

Approval Date: August 12, 2025
Effective Date: April 1, 2025

New Hampshire

This amendment proposed to increase the Medically Needy income limit.

Approval Date: August 11, 2025
Effective Date: July 1, 2025
Topics: Eligibility Medicaid and CHIP Program (MACPro)

Hawaii

This amendment revises the language concerning nursing facility services to comport with the requirement that nursing facility services are ordered by and provided under the direction of a physician.

Approval Date: August 7, 2025
Effective Date: May 1, 2025