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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 29 results
Transmittal Number: OR-24-0009
State: Oregon
Summary: This amendment removes the requirement to obtain employer sponsored insurance as a condition of Medicaid eligibility.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: SC-23-0019
State: South Carolina
Summary: This amendment proposes to align the limitations on non-covered medical expenses with the current Medicaid coverage and benefits.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Benefits
  • Eligibility
Links:
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Transmittal Number: OR-23-0033
State: Oregon
Summary: This amendment is to disregard certain compensation payments from income and resources when determining financial eligibility.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
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Transmittal Number: OR-23-0010
State: Oregon
Summary: This SPA is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORD Act, Pub. L. No. 115-217, section 1002.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SC-23-0002
State: South Carolina
Summary:  This amendment proposed to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Eligibility
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OR-19-0004
State: Oregon
Summary: Revises the alternative paper application to align with the state’s online eligibility system
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: OR-20-0010
State: Oregon
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to designate Contracted Community Partner organizations as qualified entities to make presumptive eligibility determinations; consider individuals evacuated from the state due to the emergency to continue to be residents; allow flexibility for mobile testing for COVID-19; and waive medication supply limits when appropriate to reduce exposure risk. In addition, this amendment will allow for changes in reimbursement policies and adjustment of payment rates for certain services and providers.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Eligibility
  • Financing & Reimbursement
  • Benefits
  • Prescription Drugs
Links:
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Transmittal Number: SC-20-0007
State: South Carolina
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Eligibility
Links:
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Transmittal Number: OR-18-0003
State: Oregon
Summary: This SPA updates the Hospital Presumptive Eligibility (HPE) application to align with the state's new eligibility system.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Program Administration
Links:
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Transmittal Number: SC-17-0001
State: South Carolina
Summary: Allows for eligibility for certain pregnant women and children as described in section 1903(v)(4) and 2107 (e)(1)(J) of the Social Security Act and who are otherwise eligible for assistance under the state plan (template S89).
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Eligibility
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT