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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 35 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: IL-23-0021
State: Illinois
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend certain COVID-19 disaster relief policies originally approved in Disaster Relief SPAs IL-20-0004, IL-20-0013, IL-21-0004, IL-21-0005, and IL-23-0016. This amendment also proposes to add a new Section 7.4.C to temporarily increase the asset test to $17,500 for Medicaid beneficiaries determined eligible through the Aged, Blind, and Disabled category.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
  • Eligibility
Links:
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Transmittal Number: IL-23-0046
State: Illinois
Summary: This SPA increases the monthly personal needs allowance for Medicaid beneficiaries residing in nursing facilities.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: IL-21-0019
State: Illinois
Summary: This SPA elects the Individuals Eligible for Family Planning Services (“Family Planning”) eligibility group and elect to add Presumptive Eligibility (PE) for the Family Planning eligibility group.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
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: IL-23-0010
State: Illinois
Summary: The state adopts 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:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
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Transmittal Number: IL-23-0009
State: Illinois
Summary: This amendment proposes to allow annual increases to the maintenance needs standard and resource standard for the community spouse in a post-eligibility determination.
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Eligibility
  • Benefits
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:
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Transmittal Number: IL-22-0020
State: Illinois
Summary: The state elect its option to provide 12 months of postpartum Medicaid coverage to individuals who were pregnant when enrolled in Medicaid.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Coverage
Links:
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Transmittal Number: IL-21-0010
State: Illinois
Summary: Proposes to make changes to post-eligibility treatment of income (PETI) by imposing reasonable limits on deductions for incurred medical or remedial care expenses
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT