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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 53 results
Transmittal Number: MA-24-0036
State: Massachusetts
Summary: This amendment strikes references of a 60-day postpartum policy to the 12-month postpartum policy as approved under SPA TN 22-0014.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
Links:
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Transmittal Number: AS-24-0001
State: American Samoa
Summary: This amendment is to temporarily suspend otherwise covered benefits for the period January 1, 2024 through September 30, 2024 in response to the territory’s local funding shortfall.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Benefits
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MA-24-0004
State: Massachusetts
Summary: This amendment is to update the Standard Alternative Benefit Plan to update Optometrists' Services.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Alternative Benefit Plan
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MA-24-0005
State: Massachusetts
Summary: This amendment is to update the Care Plus Alternative Benefit Plan to update Optometrists' Services.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Alternative Benefit Plan
Links:
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Transmittal Number: MA-23-0051
State: Massachusetts
Summary: This amendment establishes a Coordinating, Aligned, Relationship-centered, Enhanced Support (CARES) Targeted Case Management (TCM) benefit for children.  This new CARES TCM will provide intensive support in care planning and coordination of services for eligible medically complex MassHealth members younger than 21.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Targeted Case Management
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MA-23-0015
State: Massachusetts
Summary: This amendment adds enhanced mobile crisis services to the Medicaid state plan.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
  • Benefits
Links:
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Transmittal Number: AS-23-0001
State: American Samoa
Summary: The purpose of this SPA to implement mandatory coverage and reimbursement of COVID-19 testing, vaccine and vaccine administration, and treatment in accordance with Section 9811 of the American Rescue Plan (ARP) Act.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Reimbursement
Links:
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Transmittal Number: MA-22-0025
State: Massachusetts
Summary: This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MA-22-0014
State: Massachusetts
Summary: This SPA provides Massachusetts with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MA-21-0032
State: Massachusetts
Summary: Update the Standard Alternative Benefit Plan (ABP) to confirm coverage of Durable Medical Equipment (DME) services.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT