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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 1466 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-24-0012
State: New Mexico
Summary: This SPA allows New Mexico to enter into Value-Based Agreements with drug manufacturers on a voluntary basis.
Approval Date:
Effective Date:
Topics:
  • Value Based Purchasing
Links:
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Transmittal Number: NM-23-0018-A
State: New Mexico
Summary: This amendment updates the Alternative Benefit Plan (ABP) to add Chiropractic services.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
Links:
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Transmittal Number: NY-24-0074
State: New York
Summary: This SPA updates the reimbursement methodology of covered outpatient and prescribed drugs as well as physician administered drugs.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
  • Prescribed Drugs
  • Covered Outpatient Drug
  • Physician Administered Drugs
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
Links:
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Transmittal Number: NY-24-0085
State: New York
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.
Approval Date:
Effective Date:
Topics:
  • Health Homes
Links:
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Transmittal Number: NY-24-0072
State: New York
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.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: NY-24-0084
State: New York
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.
Approval Date:
Effective Date:
Topics:
  • Health Homes
Links:
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Transmittal Number: NM-24-0011
State: New Mexico
Summary: This SPA will update the PACE Rate methodology to amend the Amount Would Otherwise Have Been Paid (AWOP) methodology.
Approval Date:
Effective Date:
Topics:
  • Coverage
Links:
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Transmittal Number: NY-18-0015
State: New York
Summary: This plan amendment proposes a specified increase of 3.25 percent to reimbursement rates for intermediate care facilities for the intellectually disabled) (ICF/ID).
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT