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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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Showing 51 to 60 of 458 results
Transmittal Number: WA-23-0033
State: Washington
Summary: This SPA updated the rates for outpatient Sole Community Hospitals.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-0029
State: Washington
Summary: The purpose is to updates the services payable in addition to the Administrative Day rate.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-2014-2
State: Washington
Summary: This amendment is to expand the Oral Health Connections Pilot project until December 31, 2023, modifying the age range for pregnant clients from 21 to 64, to, 16 and older, and changing the age range for diabetic customers from 21 to 64, to, 21 and older. Clients who were qualified for both Medicaid and Medicare (dual eligibles) will also be able to participate.
Approval Date:
Effective Date:
Topics:
  • ABP
Links:
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Transmittal Number: WA-23-0050
State: Washington
Summary: This SPA proposes to bring Washington into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Approval Date:
Effective Date:
Topics:
  • Covered Outpatient Drug
  • Prescribed Drugs
  • Reimbursement
Links:
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Transmittal Number: WA-23-0034
State: Washington
Summary: This SPA updated the ambulance transportation quality assurance fee expiration date from June 30, 2024 to June 30, 2028
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-0045
State: Washington
Summary: This amendment is to increase the Personal Needs Allowance (PNA) from to $100 and to $200 for couples.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: WA-23-0027
State: Washington
Summary: This amendment will update SPA language regarding appropriate provider types to reflect current Care Coordination Organizations and will modify language to better align with current program policy, and updates rates for the Health Home program.
Approval Date:
Effective Date:
Topics:
  • Home Health
  • Medicaid and CHIP Program (MACPro)
Links:
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Transmittal Number: WA-23-0031
State: Washington
Summary: To update and simplify the description of inpatient hospital supplemental payments for the new Safety Net Program.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-0044
State: Washington
Summary: This amendment is to update the section of the Medicaid State Plan that ensures compliance and enforcement for Intermediate Care Facilities for People with Developmental Disabilities (ICF/IID).
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: WA-23-0020
State: Washington
Summary: This amendment is to comply with requirements regarding methods and procedures to safeguard against unnecessary utilization of care and services.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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