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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 23 results
Transmittal Number: NM-24-0015
State: New Mexico
Summary: This plan amendment proposes to move away from cost-based reimbursement for Accredited Residential Treatment Centers for Adults with Substance Use Disorders (AARTCs) services and instead proposes a prospective fee schedule system.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NM-24-0005
State: New Mexico
Summary: This plan amendment allows hospitals to be reimbursed for implementing a plan of care for infants in the Comprehensive Addiction Recovery Act (CARA) program separate from the DRG.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: NM-24-0007
State: New Mexico
Summary: This plan amendment increases reimbursement rates for inpatient and outpatient hospitals, and nursing facilities.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: NM-23-0013
State: New Mexico
Summary: To update the State Plan as Tribal Nursing Facilities receive a Tribal 638 authority designation to be reimbursed at the OMB publishing rate.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NM-23-0012
State: New Mexico
Summary: This SPA proposes increase to Medicaid provider payment rates for multiple services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: NM-23-0006
State: New Mexico
Summary: This state plan amendment clarifies coverage of crisis intervention services and service rates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
  • Benefits
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Transmittal Number: NM-23-0010
State: New Mexico
Summary: This SPA proposes Family Infant Toddler (FIT) Rate Increases.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NM-23-0001
State: New Mexico
Summary: This SPA proposes reimbursement for providers of Personal Care Services (PCS) and Private Duty Nursing (PDN) services under the Early Periodic Diagnostic and Treatment (EPSDT) benefit will be set at the same rate as 1915(c) provider rates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NM-22-0019
State: New Mexico
Summary: This SPA proposes a temporary rate increases for providers of personal care services (PCS) and private duty nursing (PDN) under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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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:
SHARE THIS MEDICAID STATE PLAN AMENDMENT