As part of a strategy to increase transparency, enhance efficiency, and reduce burden for States in the review and approval process of State Plan Amendments, CMS committed to providing a tool kit to assist States in the development of complete submissions, and facilitate quicker adjudication of SPAs. This page provides a collection of existing preprints, templates, checklists and other existing guidance that will be enhanced as more tools are developed.
Tools for All SPAs
- CMS-179 form and updated instructions
- Fillable CMS-179 form
- Training on SPA Submission and Processing For State Medicaid Agencies
Payment SPA Tools
- Medicaid Funding Questions
- Fee For Service SPA Submission Package Completeness Checklist
- Federal Requirements for Comprehensive State Plan Payment Methodologies
- Quality Incentive Payments in the State Plan
- Guidance on Annual Upper Payment Limit Demonstrations Public Notice and Public Process Requirements for Changes to Medicaid
- Public Notice and Process
- Bundled Rate Payment Methodology
- Clinic Payment Methodology
Eligibility and Administration SPA Tools
Premiums and Cost-Sharing SPA Tools
Pharmacy SPA Tools
- Summary Sheet - Reimbursement Requirements in the Covered Outpatient Drug final rule with comment
- Cures Act
- Smoking Cessation and Benzo/Barbs
Home and Community Based Services SPA Tools
- 1915 (i) Pre-Print – State Plan Home and Community Based Services
- Technical Guide for 1915(c) Waivers including Instructions and Review Criteria
- 1915 (j) Pre-Print – Self Directed Personal Assistance Services Under the State Plan
- 1915(k) Template and Technical Guide – Community First Choice (CFC)
- HCBS Standard Review Qs (CFC)
- HCBS Authorities
- Toolkit for HCBS Settings Requirements
- HCBS Training on a Variety of Subjects
Benefits and Coverage SPA Tools
Coverage of Services for Eligible Juveniles who are Inmates of a Public Institution
- Attachment 3.1-M Page 1 and 2 Preprint - Mandatory Coverage of Eligible Juveniles who are Inmates of a Public Institution Post Adjudication of Charges
- Supplement to Attachment 3.1-A and 3.1-B Preprint – Targeted Case Management Services for Eligible Juveniles
- Attachment 3.1-M Page 3 Preprint - Optional Coverage for Eligible Juveniles Who are Inmates of a Public Institution Pending Disposition of Charges
- Additional information about the CAA 2023 Sections 5121 & 5122 - Juvenile Justice.
Coverage of Routine Patient Cost in Qualifying Clinical Trials - Consolidated Appropriations Act
- SPA Template: Supplement to Attachment 3.1-A for 1905(a)(30) for Coverage of Routine Patient Cost in Qualifying Clinical Trials
- SPA Template: Supplement to Attachment 3.1-B for 1905(a)(30) for Coverage of Routine Patient Cost in Qualifying Clinical Trials
- Medicaid Attestation Form on the Appropriateness of the Qualified Clinical Trial Form
Coverage of New Mandatory Benefits Under Section 9811 of the American Rescue Plan (ARP)
- SPA Template: Vaccine and Vaccine Administration at Section 1905(a)(4)(E) of the Social Security Act
- SPA Template: COVID-19 Testing at section 1905(a)(4)(F) of the Social Security Act
- SPA Template: COVID-19 Treatment at section 1905(a)(4)(F) of the Social Security Act
- Medicaid Section 1135 Waiver of SPA Submission Requirements Template
Mandatory MAT Tools-SUPPORT Act Section 1006(b)
- SPA Template: Supplement to Attachment 3.1-A for 1905(a)(29) Medication-Assisted Treatment (MAT)
- SPA Template: Supplement to Attachment 3.1-B for 1905(a)(29) Medication-Assisted Treatment (MAT)