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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 967 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: LA-25-0006
State: Louisiana
Summary: This plan amendment is to extend the temporary rates for intermediate care facilities for individuals with intellectual disabilities (ICF/IID).
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: LA-24-0017
State: Louisiana
Summary: This amendment makes provisions governing the medical transportation program to establish guidelines for the administration and distribution of Elevated Level of Care (ELOC) services by non-emergency medical transportation (NEMT) vendors that meet the criteria to provide an ELOC service to Medical beneficiaries, and to clarify language regarding non-emergency medical ambulance transportation (NEAT) services.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
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: 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: LA-24-0021
State: Louisiana
Summary: This amendment allows provisions governing the Pharmacy Benefits Management Program to update the copay tier payment schedule to align with the U.S. Department of Health and Human Service, CMS, recommended guidelines.
Approval Date:
Effective Date:
Topics:
  • Premiums
  • Cost Sharing
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:
SHARE THIS MEDICAID STATE PLAN AMENDMENT