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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 842 results
Transmittal Number: MA-23-0042
State: Massachusetts
Summary: This amendment proposes to clarify certain licensed practitioner services including chiropractic, optometrist, and hearing instrument specialist.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Other Licensed Practitioners
Links:
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Transmittal Number: MA-23-0004
State: Massachusetts
Summary: This amendment adds new coverage and payment methodologies for certain behavioral services under rehabilitative services.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
Links:
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Transmittal Number: MA-23-0014
State: Massachusetts
Summary: This amendment adds new coverage and payment methodologies for standard and intensive outpatient behavioral services under rehabilitative services.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
Links:
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Transmittal Number: NC-23-0024
State: North Carolina
Summary: This plan amendment increases the rates for maternal health services offered under the Other Licensed Practitioner benefit.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NC-23-0027
State: North Carolina
Summary: This plan amendment updates the Medicaid Private Duty Nursing (PDN) rates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MA-23-0008
State: Massachusetts
Summary: This amendment updates the coverage and payment methodologies for substance use disorder clinic services.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
  • Clinic
  • Drugs and Related Services
Links:
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Transmittal Number: NC-23-0031
State: North Carolina
Summary: This amendment is to include the new adult group in Community Care of North Carolina (CCNC) primary care case management entity (PCCMe) program eligibility.
Approval Date:
Effective Date:
Topics:
  • Managed Care
  • Medicaid Expansion
Links:
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Transmittal Number: NC-23-0032
State: North Carolina
Summary: This amendment is to include the new adult group in Eastern Band of Cherokee Indians (EBCI) Tribal Option primary care case management entity (PCCMe) program eligibility.
Approval Date:
Effective Date:
Topics:
  • Managed Care
  • Medicaid Expansion
  • Tribal/Indian Health Services
Links:
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Transmittal Number: NC-23-0029
State: North Carolina
Summary: This amendment is to define the Alternative Benefit Plan (ABP) that will be used to implement certain requirements for the new North Carolina Medicaid Expansion eligibility group as required by SL 2023-7.  The Act allows for the inclusion of Medicaid eligibility to individuals aged 19‐64 with incomes at or below 133 percent of the federal poverty level who are not enrolled in or eligible for Medicare, consistent with the new adult group eligibility criteria as defined by the Affordable Care Act.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
  • Medicaid Expansion
Links:
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Transmittal Number: MA-23-0005
State: Massachusetts
Summary: This amendment updates the coverage and payment methodologies for Children's Behavioral Health Initiative (CBHI). 
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT