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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: FL-11-016
State: Florida
Summary: This amendment allows self-direction for the less than 21 years old population eligible to self-direct their State Plan personal care services.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: KY-12-001
State: Kentucky
Summary: This State Plan amendment establishes a timeline of a look back period for the State to review Third Party Liability claims. Specifically this amendment will allow the Kentucky Department for Medicaid Services to look back three (3) years for payment for any healthcare item or services submitted not later than three (3) years after the date such item or services were provided.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VI-11-001
State: Virgin Islands
Summary: Implements a PBM program to provide drugs covered on the formulary list, except excluded drugs covered under Part D.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Prescription Drugs
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MT-12-005
State: Montana
Summary: State is seeking an exception to the January 1, 2012 implementation date described in theFinal Rule.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: KY-12-002
State: Kentucky
Summary: The purpose of this State Plan Amendment is to provide assurances that the State is in compliance with the screening and enrollment of providers pursuant to 42 CFR 445.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: PA-11-028
State: Pennsylvania
Summary: This amendment modifies the State's methods for setting peer group medians and pricing for the special rehabilitation nursing facilities (SRF).
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: IN-08-009
State: Indiana
Summary: This amendment proposes implementation of lead case management and enviromental lead investigation services for individuals who tested for elevated blood lead levels.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: PA-11-027
State: Pennsylvania
Summary: This amendment adds language that allows Pennsylvania to recover overpayments of disproportionate share (DSH) payments that exceed a hospital's specific DSH limit as defined by section 1923(g) of the Social Security Act.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: NC-11-034
State: North Carolina
Summary: This amendment is required due to the State administrative decision to adjust the supplemental pages for rehabilitation services.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: AZ-10-009
State: Arizona
Summary: This SPA clarifies the service descriptions and provider qualifications for behavioral health services provided under the rehabilitation services component of the State Plan.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Eligibility
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT