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SPA and 1915 Waiver Processing
The Centers for Medicare & Medicaid Services (CMS) is committed to engaging with states to make the State Plan Amendment (SPA) and 1915(b) and 1915(c) waiver approval processes more transparent, efficient, and less burdensome. CMS conducted an internal assessment and consulted with the National Association of Medicaid Directors (NAMD), state Medicaid directors, staff and other stakeholders to develop strategies to streamline the process. This page provides information on CMS’ SPA and waiver review processes and tools for state use in the development of SPA and 1915 waiver submissions.