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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 191 results
Transmittal Number: WA-25-0007
State: Washington
Summary: This plan amendment updated the fee schedule effective dates for several Medicaid programs and services.
Approval Date:
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Topics:
  • Reimbursement
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Transmittal Number: WA-24-0045
State: Washington
Summary: This plan amendment revises tier levels under “Methods & Standards for Establishing Payment Rates” in the 1915(i) Home and Community Based Services section of the Medicaid State Plan.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: WA-24-0049
State: Washington
Summary: This plan amendment updated the fee schedule effective dates for several Medicaid programs and services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: WA-24-0043
State: Washington
Summary: This plan amendment updates the outdated information about Small Rural Indigent Assistance Disproportionate Share Hospital payments and clarify references to Medicaid clients.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: WA-24-0039
State: Washington
Summary: This plan amendment updates the case mix data source from the Resource Utilization Groups (RUGs) to the Patient-Driven Payment Model (PDPM).
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: WA-24-0040
State: Washington
Summary: This plan amendment updated the effective date of the fee schedules for Home and Community Based Services (HCBS).
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: WA-24-0036
State: Washington
Summary: This plan amendment updated language to clarify current practices, updated the link for Washington’s Medicaid State Plan, and other clarifications. These changes are for clarification purposes only; payment methodologies are not changing.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: WA-24-0037
State: Washington
Summary: This plan amendment clarifies mental health rate determination language without modifying the methodology for setting rates.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: WA-24-0025
State: Washington
Summary: This plan amendment clarified the language and payment methodology for Rehabilitative/Behavioral Health Services.
Approval Date:
Effective Date:
Topics:
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Transmittal Number: WA-24-0029
State: Washington
Summary: This plan amendment updates the per diem rates for non-publicly owned hospitals will be increased and payment for services provided under the Substance Using Pregnant People program is an exception to the per diem rate determination for specialty services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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