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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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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: NM-20-0019
State: New Mexico
Summary: Effective July 1, 2020, this amendment increases the number of FTEs for the states Graduate Medical Education (GME) program which will provide access to care in more rural areas of the state. Both public and private hospitals will be allowed to participate. 
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Current State Plan
Links:
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Transmittal Number: NM-21-0005
State: New Mexico
Summary: Effective January 01, 2021, this amendment adds substance use disorder (SUD) as an additional eligibility criterion for Health Home Services. For payments made to Health Homes providers for Health Homes participants who newly qualify based on the Health Homes program’s additional condition coverage under this amendment, a medical assistance percentage (FMAP) rate of 90% applies to such payments for 8 quarters from the effective date of this SPA. The FMAP rate for payments made to health homes providers will return to the state's published FMAP rate at the end of the enhanced match period.
Approval Date:
Effective Date:
Topics:
  • Federal Financial Match
  • Financing & Reimbursement
  • Eligibility
  • Program Administration
  • Current State Plan
Links:
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Transmittal Number: NM-19-0016
State: New Mexico
Summary: Establishes a new minimum encounter rate for Federally Qualified Health Centers (FQHCs) based upon the national Medicare Prospective Payment System (PPS) base rate
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Current State Plan
  • Program Administration
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: NM-19-003
State: New Mexico
Summary: Adds Substance Use Disorder (SUD) Continuum of Services to the Alternative Benefit Plan (ABP).
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Current State Plan
  • Program Administration
Links:
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Transmittal Number: NM-19-0002
State: New Mexico
Summary: Proposes to add a Substance Use Disorder (SUD) Continuum of Services to the New Mexico State plan.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
Links:
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Transmittal Number: NM-19-0009
State: New Mexico
Summary: Adjust state plan to disregard census bureau income\/wages from the calculation of Medicaid eligibility.
Approval Date:
Effective Date:
Topics:
  • Current State Plan
  • Eligibility
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT