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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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Transmittal Number: DC-11-05
State: District of Columbia
Summary: Wholesale Acquisition Cost.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: NY-09-23A
State: New York
Summary: The SPA provides for the continuation of various cost saving measures, which had been enacted previously and were to sunset, for hospital outpatient clinic, emergency department, certified home health agency, adult day health and freestanding clinic services.
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Effective Date:
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  • Financing & Reimbursement
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Transmittal Number: VT-11-029
State: Vermont
Summary: This SPA transmitted revisions to reimbursement language for transportation and therapies, and clarifications to coverage language for home health, private duty nursing, therapies, hospice, respiratory care, and certified pediatric/family nurse practitioner services.
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  • Financing & Reimbursement
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Transmittal Number: VT-11-023A
State: Vermont
Summary: This SPA transmitted a proposed amendment to Vermont's approved Title XIX State Plan to implement nonpayment provisions for healthcare acquired conditions/provider preventable conditions as required by 42 CFR 447.26.
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Transmittal Number: CO-11-042
State: Colorado
Summary: Revises the huerarchy of supplemental Medicaid payments, increases supplemental payments; reduces the aggregate state-wide per diem rate, and provides for other minor clarifications for nursing facility reimbursement.
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Effective Date:
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Transmittal Number: CO-11-040
State: Colorado
Summary: Revises supplemental Medicaid inpatient and Disproportionate Share Hospital payments to CO Hospitals.
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Transmittal Number: MN-11-12
State: Minnesota
Summary: Revises methods and standards for establishing payment rates for inpaitent hospital services.
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Effective Date:
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Transmittal Number: MI-11-006
State: Michigan
Summary: Revises the methodology for setting reimbursement rates for inpatient hospital services.
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Effective Date:
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Transmittal Number: PA-11-013
State: Pennsylvania
Summary: Rate methodology for LIFE sites operating under Medicare and Medicaid Capitation Program of All-Inclusive Care for the Elderly.
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Transmittal Number: NY-11-32
State: New York
Summary: Align Medicare Part B Clinic Coinsurance With Medicaid Coverage and Rates FMAP = 50% (7/1/11 forward).
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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