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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 271 to 280 of 393 results
Transmittal Number: NJ-14-0004
State: New Jersey
Summary: Updates the fee schedule for various non-institutional services and provides information on how to locate the fee schedules.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: NJ-14-0009
State: New Jersey
Summary: Establishes a new pathway (Miller Trust) for medically needy categories to establish Medicaid eligibility.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: WY-14-013
State: Wyoming
Summary: This SPA concerns the implementation of a Primary Care Medical Home through a voluntary PCCM authority to allow for Wyoming Medicaid to pay the PCCM entities a Per Member/Per Month case management fee for managing the health care needs in a primary care medical home setting and for reporting quality measures to the State, in addition to payments made on a FFS basis.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: NJ-14-03 T
State: New Jersey
Summary: Temporary Presumptive Eligibility.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Program Administration
Links:
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Transmittal Number: NJ-13-0025-MM4
State: New Jersey
Summary: Incorporates the Single State Agency SPA into New Jersey's Medicaid state plan in accordance with the Affordable Care Act.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: NJ-14-07
State: New Jersey
Summary: This SPA proposes to terminate mandatory enrollment into Managed Care because the managed care amendment was subsumed in NJ's 1115 waiver.
Approval Date:
Effective Date:
Topics:
  • Managed Care
  • Program Administration
Links:
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Transmittal Number: WY-14-009
State: Wyoming
Summary: This amendment proposes to remove the drug categories of barbiturates, benzodiazepines and smoking cessation drugs from the list of drugs that may be excluded or otherwise restricted from coverage from the state plan effective January 1, 2014 in accordance with the provisions of section 2502 of the Affordable Care Act which amends section 1927(d)(2) of the Social Security Act by removing barbiturates, benzodiazepines and agents used to promote smoking cessation from the list of drugs a state Medicaid program may exclude from coverage or otherwise restrict.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
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Transmittal Number: WY-13-0012-MM4
State: Wyoming
Summary: Addresses Single State Agencies Delegation of Appeals and Determinations.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: WY-13-0008-MM1
State: Wyoming
Summary: Incorporates MAGI-Based Mandatory and Optional Eligibility Groups Requirements.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: WY-14-011
State: Wyoming
Summary: Updates Reimbursement Methodology for Psychiatric Residential Treatment Facilities (PRTFs).
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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