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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 111 to 120 of 727 results
Transmittal Number: OR-23-0023
State: Oregon
Summary: This SPA changed the telehealth rates used during the COVID-19 Public Health Emergency (PHE) to rates based on Relative Value Units (RVUs) multiplied by the Oregon conversion factor.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: OR-23-0024
State: Oregon
Summary: This SPA has been submitted to allow the state to enter outcome-based agreements with manufactures on a voluntary basis.
Approval Date:
Effective Date:
Topics:
  • Value Based Purchasing
  • Prescribed Drugs
Links:
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Transmittal Number: WA-23-0036
State: Washington
Summary: This SPA updated the daily rates for Consumer Directed Employers (CDE) for Individual Provider (IP) training for State Fiscal Year 2023.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: OR-23-0019
State: Oregon
Summary: To increase the rate for NEMT mileage, meals, and lodging and base them on a percentage of the IRS standard rates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-0015
State: Washington
Summary: This SPA updates the description of the payment rate for Collaborative Care Services based on Medicare rates that are in effect at the time of service.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-0047
State: Washington
Summary: This amendment adds Dental Health Aide Therapists per Court Order on January 12, 2023, and will align original SPA 17-0027 submitted on August 22, 2017, into the current Washington State Medicaid plan to cover and reimburse Dental Health Aide Therapists in accordance with state Senate Bill 5079 (codified into law at RCW 70.350.020).
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: OR-23-0017
State: Oregon
Summary: To continue the 1915(k) rate model approved in the Disaster relief SPA 22-0022 past the PHE period.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-0028
State: Washington
Summary: Substance Using Pregnant People - name change from Chemically Using Pregnant Women
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-0018
State: Washington
Summary: Updates Outpatient Hospital Services payment information by removing references to Outpatient Hospital Rates as a payment method under Outpatient Prospective Payment System (OPPS). This method is outdated and no longer used.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: WA-23-0040
State: Washington
Summary: Amended the Community First Choice (CFC) program to add an option that allows level of care assessments to be completed remotely when an in-person visit is not possible and also adds language that allows participants and providers to finalize the person-centered plan with an electronic signature, including voice signature.
Approval Date:
Effective Date:
Topics:
  • Home and community based services
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT