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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 141 to 150 of 480 results
Transmittal Number: NC-21-0014
State: North Carolina
Summary: Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to rescind a temporary rate increase for inpatient hospital services as approved under Disaster Relief SPA TN 20-0009.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: NC-21-0015
State: North Carolina
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to rescind a temporary rate increase for outpatient hospital services as approved under Disaster Relief SPA TN 20-0009.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NC-21-0017
State: North Carolina
Summary: This SPA will amend the State Plan pursuant to North Carolina Disaster State Plan Amendment (SPA) 20-0016 and will revise the methodology to include (a) an update to 2018 as the cost report base year for determining provider specific Prospective Payment System (PPS) rates and (b) adding an Alternative Payment Methodology (APM) in compliance with CMS Companion Letter to North Carolina Disaster Relief State Plan Amendment (SPA) 20-0016.

 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NC-21-0023
State: North Carolina
Summary: Allows individuals over the age of 21 to access Research-Based Intensive Behavioral Health Treatment (RBI-BHT) that prevent or minimize the disabilities and behavioral challenges associated with Autism Spectrum Disorder (ASD) and promote, to the extent practicable, the adaptive functioning of a beneficiary under the Preventative Services benefit.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: NC-21-0019
State: North Carolina
Summary: Amends the Medicaid State Plan to include Mobile Crisis Management and to assign a reimbursement rate of $90.00 per 15-minute increment
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NC-21-0016
State: North Carolina
Summary: This plan amendment revises the FQHC methodology to include (a) an update to 2018 as the cost report base year for determining provider specific Prospective Payment System (PPS) rates and (b) adding an Alternative Payment Methodology (APM) in compliance with CMS Companion Letter to North Carolina Disaster Relief State Plan Amendment (SPA) 20-0016. 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: NC-21-0006
State: North Carolina
Summary: Adds Medication Assisted Treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: NC-21-0018
State: North Carolina
Summary: Updates Program of All-Inclusive Care for the Elderly (PACE) Services
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: NC-21-0012
State: North Carolina
Summary: Approves a template that will authorize the state to enter Value-Based purchasing (VBP) rebate agreements with drug manufacturers for drugs provided under the Medicaid program
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: NC-21-0011
State: North Carolina
Summary: Adds a tribal Primary Care Case Management Program to the State Plan
Approval Date:
Effective Date:
Topics:
  • Indian Health Services
Links:
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