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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 101 to 110 of 218 results
Transmittal Number: DE-17-011
State: Delaware
Summary: This amendment modifies Delaware's Alternative Benefit Plan (ABP) to update the base benchmark plan already in use to plan year 2014 from plan year 2012 and to align with the changes made to Delaware's Medicaid State Plan since ABP implementation.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: DE-17-012
State: Delaware
Summary: Reimbursement to out-of-state PRTFs to include a negotiated rate.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: DE-17-0010
State: Delaware
Summary: This amendment modifies the Modified Adjusted Gross Income (MAGI)-Based Eligibility Groups to add the Individuals Over 133% FPL and Under Age 65 group related specifically to an 1115 demonstration.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: PR-17-0001
State: Puerto Rico
Summary: Incorporates the MAGI-Based Income Methodologies into Puerto Rico's state plan in accordance with the Affordable Care Act.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: DE-17-008
State: Delaware
Summary: This amendment recognizes incurred medical or remedial care expenses as those that are incurred during the three months preceding the month of application.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: DE-17-006
State: Delaware
Summary: This amendment allows lactation counseling services as a separately reimbursed service.
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: DE-16-011
State: Delaware
Summary: To establish coverage and reimbursement methodologies for targeted case management services for individuals with intellectual disabilities.
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: DE-17-003
State: Delaware
Summary: This amendment provides a mechanism for Federally Qualified Health Centers (FQHC) to be compensated for Long-Acting Reversible Contraceptives (LARCs) that are not included in the FQHC's rates
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: DE-17-002
State: Delaware
Summary: This amendment clarifies the reimbursement methodology for covered outpatient drugs.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
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Transmittal Number: DE-17-001
State: Delaware
Summary: Expands coverage and allow reimbursement for chiropractors' services for all Medicaid eligible individuals.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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