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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 535 results
Transmittal Number: KS-23-0022
State: Kansas
Summary: This amendment is to establish coverage of dentures and partials for adults who meet medical necessity criteria.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
Links:
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Transmittal Number: KS-21-0013
State: Kansas
Summary: This amendment expands PE to include the Parents and other Caretaker Relatives, Former Foster Care and Breast

and Cervical Cancer groups, in addition to Children and Pregnant Women, and to allow the state-designated Qualified Entities to complete PE determinations for all groups covered in PE.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
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Transmittal Number: NJ-23-0009
State: New Jersey
Summary: To adopt the optional Work Incentives eligibility group and incorporate additional disregards in the determinations of financial eligibility for the Ticket to Work-Basic eligibility group.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: KS-23-0027
State: Kansas
Summary: This plan amendment will set the laboratory reimbursement rates to be between 85% and 100% of Medicare.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: KS-23-0021
State: Kansas
Summary: Due to passage of legislation during the 2023 legislature session, select emergency transportation reimbursement rates have been increased.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: KS-23-0019
State: Kansas
Summary: The SPA increases the DMEPOS reimbursement rates to 80% of Medicare. The SPA will also add self-monitoring blood pressure (BP) devices to the DME list for pregnant women at risk for gestational hypertension, and for persons with heart failure or end-stage renal disease (ESRD).
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: KS-23-0020
State: Kansas
Summary: This plan amendment increases the global pregnancy services provider reimbursement rates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: KS-23-0024
State: Kansas
Summary: This amendment is to add coverage and reimbursement of Community Health Workers services.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: KS-23-0018
State: Kansas
Summary: This plan amendment updates one of the topical fluoride treatment reimbursement rates that needs to be revised in order to match the other topical fluoride treatment rates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NJ-23-0008
State: New Jersey
Summary: This SPA provides an add-on payment for General Acute Care Critical Se1vice for Pediatric pateints who are 20 yeai·s old or younger
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT