An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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.
Summary: This amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This amendment waives the requirement of issuing trauma code mailers for all ICD-9 and ICD-10 trauma codes to recipients when used on claims submitted with the agency that signify an accident may have occurred.
Summary: This amendment proposes to remove both quantitative treatment limitations, such as visit limits, and non-quantitative treatment limitations, including prior authorization, concurrent review, and reauthorization requirements.
Summary: This amendment proposes to remove the medically monitored detoxification services from rehabilitative services benefit. This level of care will be provided in inpatient settings, aligning with the ASAM levels of care outlined in the state's 1115 SUD demonstration.
Summary: This amendment is to allow certain flexibilities related to eligibility, including allowing individuals displaced from the state due to Hurricane Helene to continue to be residents of the state; temporarily waive and modify certain requirements related to behavioral health, Long Term Services and Supports (LTSS), and dental benefits; and provide retainer payments for specific l 915(i) services, including Community Living and Supports, Supported Employment, Individual Placement and Supports, and Individual and Transitional Supports.
Summary: Assure compliance with annual mandatory Health Home core set reporting for the State of New York. This reporting includes all quality measure data for measures on the Health Home Core Set.
Summary: Technical change to align with New York statute, which allows residents of Adult Care Facilities to receive both Hospice and Assisted Living Program services without having to disenroll from either, was originally approved on February 26, 2025.
Summary: For NYS CCO/HHs Serving Individuals with I/DD to assure compliance to submit annual mandatory Health Home core set reporting for the State of New York. This reporting includes all quality measure data for the Health Home Core Set measures.
