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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 18 results
Transmittal Number: NV-21-0015
State: Nevada
Summary: This amendment proposes changes to incorporate language based on provisions for Medicaid non-emergency medical transpo1iation (NEMT) services added to Section 1902(a)(87), Title XIX of the Social Security Act, as part of the Consolidated Appropriations Act, 2021. 
Approval Date:
Effective Date:
Topics:
  • Current State Plan
Links:
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Transmittal Number: CT-21-0005
State: Connecticut
Summary: Effective January 1, 2021, this amendment incorporates various 2021 Healthcare Common Procedure Coding System (HCPCS) updates, updated the reimbursement methodology to 100% of the January 2021 Medicare Average Sales Price (ASP) Drug Pricing file for physician-administered drugs, immune globulins, vaccines and toxoids and made technical updates to the Person-Centered Medical Home (PCMH) program.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Financing & Reimbursement
Links:
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Transmittal Number: CT-20-0017
State: Connecticut
Summary: updates Attachment 3.1A/B of the Medicaid State Plan to increase the allowable units to eight hours per day with additional hours available with prior authorization for individual day program services provided to individuals residing in Medicaid-certified nursing facilities who are 21 years of age or older and have been found through the Preadmission Screening and Resident Review (PASSR) process to need such services
Approval Date:
Effective Date:
Topics:
  • Current State Plan
Links:
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Transmittal Number: CT-20-0003
State: Connecticut
Summary: Updates the optional state supplement income standard in accordance with the 2020 SSI COLA increase.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Financing & Reimbursement
Links:
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Transmittal Number: CT-20-0016
State: Connecticut
Summary: Makes technical corrections to recently approved state plan amendment TN 19-0017 (inpatient hospital supplemental payments)
Approval Date:
Effective Date:
Topics:
  • Current State Plan
Links:
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Transmittal Number: CT-20-0010
State: Connecticut
Summary: Updates the State’s Asset Verification System (AVS) reflecting the State’s decision to go from using a contractor to build the system to joining a consortium to develop an Asset Verification System
Approval Date:
Effective Date:
Topics:
  • Current State Plan
Links:
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Transmittal Number: NV-19-0013
State: Nevada
Summary: Consolidates the supervision of the Peer Supporter under the Clinical Supervisor with the Behavioral Health Community Network (BHCN) and removes the requirement of medical supervision for the provider
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Program Administration
Links:
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Transmittal Number: NV-19-0004
State: Nevada
Summary: Removal of Partial Hospitalization and Intensive Outpatient Services from 1915(i) HCBS to 1905(a).
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
  • Current State Plan
Links:
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Transmittal Number: NV-19-0020
State: Nevada
Summary: SPA proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act

 
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
  • Current State Plan
Links:
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Transmittal Number: CT-18-0016
State: Connecticut
Summary: This amends the State plan to make various changes to the reimbursement of chemical maintenance clincis including:pro-rating the weekly rate to account for weeks in which services are provided on fewer than seven days in the week, specifying in detail the services that are included in the rate, and providing for specific types of documentation regarding the services that are provided.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
Links:
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