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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 621 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: DC-25-0001
State: District of Columbia
Summary: This plan amendment is to update the fee schedule reimbursement rates for home health services.
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: NJ-24-0026
State: New Jersey
Summary: This plan amendment updates rates for COVID-19 Vaccine Administration.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: DC-25-0002
State: District of Columbia
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.
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Medicaid and CHIP Program (MACPro)
Links:
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Transmittal Number: NJ-24-0023
State: New Jersey
Summary: This SPA allows coverage of select prescribed drugs that do not meet the definition of covered outpatient drugs. Additionally, this SPA also allows reimbursement of prescribed drugs with the same reimbursement methodologies as covered outpatient drugs.
Approval Date:
Effective Date:
Topics:
  • Prescribed Drugs
  • Reimbursement
  • Covered Outpatient Drug
Links:
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Transmittal Number: NJ-24-0024
State: New Jersey
Summary: This SPA allows New Jersey to enter into Value-Based Supplemental Rebate Agreements with drug manufacturers on a voluntary basis.
Approval Date:
Effective Date:
Topics:
  • Value Based Purchasing
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: NJ-24-0028
State: New Jersey
Summary: Amends the serious emotional disability health home and assures that the state monitors and reports on health home measures in accordance with all federal requirements.
Approval Date:
Effective Date:
Topics:
  • Health Homes
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT