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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 1 to 10 of 12 results
Transmittal Number: NM-24-0011
State: New Mexico
Summary: This SPA will update the PACE Rate methodology to amend the Amount Would Otherwise Have Been Paid (AWOP) methodology.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: AS-24-0001
State: American Samoa
Summary: This amendment is to temporarily suspend otherwise covered benefits for the period January 1, 2024 through September 30, 2024 in response to the territory’s local funding shortfall.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Benefits
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-23-0011
State: New Mexico
Summary: This amendment is to add coverage for Community Health Workers/Community Health Representatives as a new reimbursable preventive service at 42 CFR 440.60.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: NM-23-0016
State: New Mexico
Summary: This amendment is to include provisional certification to the accreditation standards as specified in 42 CFR part 8, subparts A & B.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: NM-23-0003
State: New Mexico
Summary: This amendment is that the state will cover all preventive services assigned a grade of A or B by the U.S. Preventive Services Task Force (USPSTF), and all approved vaccines recommended by the Advisory Committee on Immunization Practices (ACIP), and their administration.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-22-0004
State: New Mexico
Summary: This amendment expands school-based health services (SBHS) under the Rehab benefit with the following services: 1) school health aide service; 2) developmental rehabilitative therapy (enhances existing service); 3) specialized transportation. The SPA also introduces a new reimbursement methodology for SBHS.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
Links:
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Transmittal Number: NM-23-0002
State: New Mexico
Summary: This amendment approved that the state will pay for prenatal genetic screening and prenatal fetal screening to determine if the fetus has the potential to born with a genetic condition or birth defect.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: AS-22-0003
State: American Samoa
Summary: This amendment preserves approved coverage of prescription drugs, dentures, and prosthetic devices while resolving a technical duplicate page number issue in Attachment 3.1A.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: NM-22-0022
State: New Mexico
Summary: This SPA amendment is to add state plan language to prohibit age and dollar limits on services related to autism spectrum disorder.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: AS-22-0001
State: American Samoa
Summary: This amendment adds optometry services to the state plan, revises coverage of eyeglasses/contact lens, and adds a fee-for-service payment methodology for these benefits.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT